Is "Typhoid Mary" Back Among Us?

 Mary Mallon (1869-1938)

Mary Mallon, aka "Typhoid Mary,"  was an Irish-born cook and asymptomatic carrier of the typhoid virus who immigrated to the USA and worked for a number of affluent families in New York.  Wherever Mary worked an outbreak of typhoid fever followed.  She is believed to have contaminated 122 people, five of whom died.  Throughout her life, Mary denied that she was responsible for the contagion.  Her solution was to change employer frequently, eventually changing her name several times.  

Causes of typhoid fever

Typhoid fever is generally associated with drinking water contaminated with feces.   Mary was forcibly quarantined by the New York Health Department for two years and eleven months.  Her feces were repeatedly tested confirming the presence of typhoid.  The removal of her gallbladder would have prevented her from transmitting typhoid, but she refused the operation. She was released from confinement after signing an affidavit promising not to work as a cook and to practice good hygiene.  However, after two years working as a laundress, Mary changed her name and returned to her more lucrative employment as a cook.  Authorities were able to track her by following outbreaks of typhoid fever at various New York hotels and restaurants.  She was quarantined a second time in the Riverside Hospital on North Brother Island until her death, 23 years later, in 1938.

Washing hands in the Bible

Mary didn't believe in washing her hands.  She was a devoutly religious woman.  The Bible offers sacred precedence since it is widely recorded in the New Testament that Jesus and his disciples refused to wash their hands before eating. 

Is "Typhoid Mary" back among us?

Is "Typhoid Mary" back among us?  In a number of odd ways, she obviously is.  Literature about her case frequently suggests that she was treated unfairly.  She was the only individual in the USA ever incarcerated for having typhoid.  The closest legal comparison we have these days is the creation of laws for the criminalization of non-disclosure of AIDS.  In 2019, in Canada, "the House of Commons Standing Committee on Justice and Human Rights released a report on the criminalization of HIV non-disclosure. [. . . .] The committee recommended that a new law be created specifically for the transmission of HIV."

For a significant cohort of Canadians, in the context of the Covid-19 pandemic, refusal to wash hands, social distance, wear a mask and ultimately be vaccinated constitute criminal behaviours, no less so than an AIDS carrier failing to inform a sex partner or Mary Mallon anonymously working as a cook with unwashed hands.

Comparisons of anti-maskers and anti-vaxxers with "Typhoid Mary" and AIDS spreaders might seem hyperbolic to some.  However, given the scale and consequences of the Covid pandemic, the comparison is an understatement.  The consequences of an unprotected, asymptomatic Covid virus carrier moving through the community could very quickly dwarf the 122 diseases and five deaths caused by Mary Mallon or the handful of deaths and diseases caused by a narcissistic AIDS carrier.

Are the vaccinated and unvaccinated equally contagious?

Recently the CDC (Centre for Disease Control) published a report on the spread of Covid among people attending public gatherings in Barnstable County, Massachusetts, from July 3rd to 17th, 2021.  The executive summary of the one-page report states that "Cycle threshold values were similar among specimens from patients who were fully vaccinated and those who were not." This sentence was picked up by the media and widely interpreted as meaning that fully-vaccinated and unvaccinated individuals were equally contagious.  What the body of the report actually says is:

Although the assay used in this investigation was not validated to provide quantitative results, there was no significant difference between the Ct values of samples collected from breakthrough cases and the other cases. This might mean that the viral load of vaccinated and unvaccinated persons infected with SARS-CoV-2 is also similar. However, microbiological studies are required to confirm these findings.

There are so many uncontrolled, unknown variables in these sentences, it is difficult to pin down a conclusive interpretation.  To keep it simple:  In the rare event of a breakthrough case in a vaccinated person, "This might mean that the viral load of vaccinated and unvaccinated persons infected with SARS-VoV-2 is also similar," through the media, became "the viral load was identically in vaccinated and unvaccinated people, therefore they are equally contagious."  And the Centre tasked with "controlling disease" unwittingly became a source for those refusing to be vaccinated.  

Ethics and values

In May 2019, I wrote, in Ethics by Numbers, that the "ethical dilemma" wasn't here yet, but it was before us.  The moment of the dilemma is now. We now have a solution to the pandemic:  vaccines.  How do we deal with individuals who refuse to be vaccinated?  Is the ethical choice egoism and what Ayn Rand called The Virtue of Selfishness, with individuals deciding for themselves what they consider best for themselves as individuals?  Or is it time to say that what is ethical is what is best for everyone, or at least for the greatest number?

In a New York Times editorial, "If You Skip the Vaccine, It Is My 'Damn Business'," Jamelle Bouie eventually comes to consider "the larger cultural and political context of the United States."  Bouie concludes:

When you structure a society so that every person must be an island, you cannot then blame people when inevitably they act as if they are. If we want a country that takes solidarity seriously, we will actually have to build one.

The contrast with American radical individualism is the draconian utilitarianism of communist China.  The world looked on in horror as images circulated of Chinese authorities in Wuhan welding shut the doors of people with Covid-19 in order to curtail the spread of the disease.  

Can the ethical dilemma be resolved?

This is the dilemma.  Do we embrace ethical egoism and American radical individualism, sacrificing the lives of millions, in the name of liberty, freedom, personal privacy and rights?  Or do we sacrifice individual liberty and human rights, in the name of saving lives and putting an end to a global pandemic?  This contrast does not offer a better, more moral choice, just a potentially lesser evil.  

Of course, the dilemma would disappear if we could depend on enlightened individuals to do what is right for themselves and everyone around them: masking, isolation and vaccination.  Yet, even as the pandemic has taken more than four million lives, individuals, through dissembling and denial, refuse vaccination, choosing to make themselves crucibles of the virus, allowing it to thrive and mutate, becoming more deadly and contagious for the rest of us.

Perhaps the citizens of New Hampshire offer guidance.  The state motto is "Live Free or Die."  So far, sixty percent of New Hampshire residents have been fully vaccinated.  Staying alive is a sane and healthy prerequisite of living free.