4 ms·

Totally-drug-resistant tuberculosis (TDR-TB) breaking out widely is among the more terrifying nightmare scenarios of which I'm aware, and has been high on my li

Totally-drug-resistant tuberculosis (TDR-TB) breaking out widely is among the more terrifying nightmare scenarios of which I'm aware, and has been high on my list of concerns for well over a decade.[1]. Unlike more virulant diseases (think, say, Ebola), TDR-TB transmits slowly, but steadily, especially under conditions of poverty (overcrowding, poor ventilation, poor hygiene), many carriers are asymptomatic (we've seen what this does with Covid-19), and there is no cure. The only treatment is to give patients free and isolated housing, plus food, clothing and entertainment. As a friend noted, "If you execute them or put them in prison cells and feed them slop nobody goes to the doctor if they have a cough." (See: <https://web.archive.org/web/20230531181139/https://old.reddit.com/r/dredmorbius/comments/2bti96/the_nasty_thing_about_tdrtb_is_that_its/ https://web.archive.org/web/20230531181139/https://old.reddi...>). TDR-TB already exists in places such as India. If an uncontrolled outbreak were to emerge in one of the world's poor megacities, places such as Dhaka, Bangladesh; Cairo, Egypt; Kinshasa, Democratic Republic of the Congo; Lagos, Nigeria; Karachi, Pakistan; Delhi, or Mumbai, or Kolkata, India; Jakarta, Indonesia; Metro Manila, Philippines; Mexico City, Mexico; Ho Chi Minh City, Vietnam; Luanda, Angola; or in other places with public health systems which are already dysfunctional and are now under further direct attack, such as the United States of America, it's going to be a very, very, very troubling future. Cutting USAID is already beyond idiotic and short-sighted. This is simply suicidal. ________________________________ Notes: 1. See e.g., <https://web.archive.org/web/20230531181139/https://old.reddit.com/r/dredmorbius/comments/2bti96/the_nasty_thing_about_tdrtb_is_that_its/ https://web.archive.org/web/20230531181139/https://old.reddi...> <https://news.ycombinator.com/item?id=6640362 https://news.ycombinator.com/item?id=6640362>.

lazyeye 2y ago
Why is this the problem of the US taxpayer specifically? What is the responsibility of the rest of the world in all of this?
- soupfordummies 2y ago
  Is five years enough to forget how quickly diseases travel around the world? It's the equivalent of standing in front of a pool of vomit with an armful of mops while saying "hmmm, why do I gotta be the one to clean this up?"
  - mindslight 2y ago
    No, but five years is long enough to have purged the institutions that "sabotaged" Trump's first term by acknowledging reality. All hail our new reactionary Lysenkoism.
    - dredmorbius 2y ago
      Rather less than five years. More like 50 days.
  - lazyeye 2y ago
    More like 1000 people standing around a pool of vomit wondering when the other guy is gonna come and clean it up....
- dredmorbius 2y ago
  "... TB is airborne. You cannot stop it at the border. It’s spread through air – as long as you breathe, you will get it. And not just TB, but also drug-resistant TB and extreme drug-resistant TB. The current measures will probably create additional strains because there are people with interrupted treatment, there are people not diagnosed and so on." From TFA. Millions of dollars in spending ($250m -- $400m/yr, from TFA) will generate trillions of dollars in savings through avoided pandemics. The Covid-19 pandemic cost the US $14 trillion through the end of 2023: <https://healthpolicy.usc.edu/research/covid-19s-total-cost-to-the-economy-in-us-will-reach-14-trillion-by-end-of-2023-new-research/ https://healthpolicy.usc.edu/research/covid-19s-total-cost-t...> Curtailing funding without a planned drawdown or transition to other forms of support strands and makes useless assets including laboratories, screening centres, healthcare workers, and far, far, far more. The approach taken is, as I've already described, simply suicidal. Those with an capacity at comprehending basic English and applying elementary reasoning skills are encouraged to read a NY Times article which spells out the impacts of the aid curtailment on the US and its citizens and residents: "How Foreign Aid Cuts Are Setting the Stage for Disease Outbreaks" Dangerous pathogens left unsecured at labs across Africa. Halted inspections for mpox, Ebola and other infections at airports and other checkpoints. Millions of unscreened animals shipped across borders. The Trump administration’s pause on foreign aid has hobbled programs that prevent and snuff out outbreaks around the world, scientists say, leaving people everywhere more vulnerable to threatening viruses and bacteria. That includes Americans. <https://www.nytimes.com/2025/03/07/health/usaid-funding-disease-outbreaks.html https://www.nytimes.com/2025/03/07/health/usaid-funding-dise...> Archive: <https://archive.is/yvMly https://archive.is/yvMly>
spwa4 2y ago
Worse: TB is a bacterium - not a virus. A virus survives for minutes outside a host. You're prefectly safe in a classroom the day after there were 30 infected children playing in the room. A bacterium survives for months (outside of direct UV light). You must not just stay away from infected people. You should never go anywhere an infected person HAS BEEN in the last few months, with the potential exception of open air spaces. We wouldn't have face masks. We'd be back to deporting infected people to remote islands to die. Technically there is a cure for TB: cutting up people's lungs. The individual bacteria grow so large there's a decent success rate for literally cutting them out one-by-one ... obviously it does not exactly restore your previous life expectancy, and it's not a guarantee.

lazyeye 2y ago

Why is this the problem of the US taxpayer specifically? What is the responsibility of the rest of the world in all of this?

soupfordummies 2y ago
Is five years enough to forget how quickly diseases travel around the world? It's the equivalent of standing in front of a pool of vomit with an armful of mops while saying "hmmm, why do I gotta be the one to clean this up?"
- mindslight 2y ago
  No, but five years is long enough to have purged the institutions that "sabotaged" Trump's first term by acknowledging reality. All hail our new reactionary Lysenkoism.
  - dredmorbius 2y ago
    Rather less than five years. More like 50 days.
- lazyeye 2y ago
  More like 1000 people standing around a pool of vomit wondering when the other guy is gonna come and clean it up....
dredmorbius 2y ago
"... TB is airborne. You cannot stop it at the border. It’s spread through air – as long as you breathe, you will get it. And not just TB, but also drug-resistant TB and extreme drug-resistant TB. The current measures will probably create additional strains because there are people with interrupted treatment, there are people not diagnosed and so on." From TFA. Millions of dollars in spending ($250m -- $400m/yr, from TFA) will generate trillions of dollars in savings through avoided pandemics. The Covid-19 pandemic cost the US $14 trillion through the end of 2023: <https://healthpolicy.usc.edu/research/covid-19s-total-cost-to-the-economy-in-us-will-reach-14-trillion-by-end-of-2023-new-research/ https://healthpolicy.usc.edu/research/covid-19s-total-cost-t...> Curtailing funding without a planned drawdown or transition to other forms of support strands and makes useless assets including laboratories, screening centres, healthcare workers, and far, far, far more. The approach taken is, as I've already described, simply suicidal. Those with an capacity at comprehending basic English and applying elementary reasoning skills are encouraged to read a NY Times article which spells out the impacts of the aid curtailment on the US and its citizens and residents: "How Foreign Aid Cuts Are Setting the Stage for Disease Outbreaks" Dangerous pathogens left unsecured at labs across Africa. Halted inspections for mpox, Ebola and other infections at airports and other checkpoints. Millions of unscreened animals shipped across borders. The Trump administration’s pause on foreign aid has hobbled programs that prevent and snuff out outbreaks around the world, scientists say, leaving people everywhere more vulnerable to threatening viruses and bacteria. That includes Americans. <https://www.nytimes.com/2025/03/07/health/usaid-funding-disease-outbreaks.html https://www.nytimes.com/2025/03/07/health/usaid-funding-dise...> Archive: <https://archive.is/yvMly https://archive.is/yvMly>

spwa4 2y ago

Worse: TB is a bacterium - not a virus. A virus survives for minutes outside a host. You're prefectly safe in a classroom the day after there were 30 infected children playing in the room. A bacterium survives for months (outside of direct UV light). You must not just stay away from infected people. You should never go anywhere an infected person HAS BEEN in the last few months, with the potential exception of open air spaces. We wouldn't have face masks. We'd be back to deporting infected people to remote islands to die. Technically there is a cure for TB: cutting up people's lungs. The individual bacteria grow so large there's a decent success rate for literally cutting them out one-by-one ... obviously it does not exactly restore your previous life expectancy, and it's not a guarantee.