Medical Science is a broad field of study aiming to understand the human body and disease. Medical doctors then apply such scientific knowledge in their practice to diagnose, treat, and prevent the illness, hoping to improve human health in general. Throughout centuries humans had experienced various diseases, including Bubonic Plague, SARS, H1N1, and COVID-19 which all caused huge impacts on humans health and took away people’s lives severely. Back then as early as during the 13th century, doctors had limited medical science knowledge so not many people’s lives were saved when facing fatal diseases, such as Bubonic Plague. This leads me to wonder: Is our medical knowledge advanced enough for the world we live in right now to cope with the unexpected diseases? My answer is YES. Over the years during the 21st century, medical science has made extraordinary advancement in three perspectives: diagnosis, treatment, and prevention, and still medical science is constantly evolving. Before further discussion of these three parts, let’s have a more detailed understanding of each fatal disease at different times first.
Bubonic Plague, known as the Black Death lasting from 1347 to 1351 in Europe, is a bacterial infection caused by the bacterium Yersinia pestis. This plague was initially passed mostly among rodents by infected fleas. Humans then contracted this plague through the bite of infected fleas or direct contact with contaminated tissues. One to seven days after exposure to the plague, flu-like symptoms develop in patients, including fever, exhaustion, headache, fatigue, muscle aches, even inflections of the blood and lungs. The most iconic symptom is a swollen gland called a "bubo". Untreated Bubonic Plague had a high fatality rate, killing about 100 million people. People in Europe stopped having the Plague, because they quarantined, decreased contact with rats, and improved sanitation and personal hygiene. Nowadays, Black Death has been controlled because people now have strong immunity. Plus, today's doctors have a greater understanding of how diseases work. Pesticides now are used to control fleas and the rats that carry them. As a result, they have developed antibiotics to treat the disease and there are even vaccines to prevent outbreaks.
SARS or Severe Acute Respiratory Syndrome occurred from 2002 to 2004 in China and East Asia countries. SARS was caused by the SARs coronavirus, or called SARS-CoV, a virus with relatively generalist properties circulating in horseshoe bats. Symptoms of SARS included high fever, cough, chills, shortness of breath, headache, and diarrhea. SARS spread from person to person through coughing, sneezing and close contact. After being exposed to SARS for 2-7 days, patients would develop dry coughs and progress to pneumonia, difficult at breathing. Worldwide over 8000 cases were reported with around 800 deaths. Older adults were at higher risk of death. During the SARS outbreak, there was no proven antiviral treatment of SARS. Patients were given regular medications to reduce fever or alleviate pain while being quarantined in the hospital. To stop the containment of SARS, the rapid identification and reporting of new cases as well as effective isolation and care of patients were key to controlling the outbreak.
H1N1 was also a major pandemic that occurred in Canada and the United States, also commonly referred to as“swine flu”. H1N1 was caused by a novel Influenza A virus, a new version that resulted from a combination of bird, swine, and human flu viruses. Symptoms of H1N1 were similar to seasonal influenza, including fever, cough, sore throat, chills, and body aches, sometimes diarrhea and vomiting. Some patients experienced severe respiratory issues and pneumonia. The first identified H1N1 case was reported in April 2009 and it spread quickly worldwide. By August 2010, the World Health Organization (WHO) announced the H1N1 pandemic was over. The global H1N1 pandemic resulted in an estimated 151700 to 575400 deaths. Treatment was largely supportive, consisting of bedrest, increased fluid consumption, and pain relievers. To prevent H1N1 and make it stop, the Centers for Disease Control and Prevention (CD) developed the H1N1 vaccine, which became a vital asset in protecting individuals and reducing the transmission of the virus.
COVID-19 is a contagious disease caused by the virus SARS-CoV-2. The first known case was identified in Wuhan, China, in December 2019. The disease quickly spread worldwide, resulting in the COVID-19 pandemic. Common symptoms include coughing, fever, loss of smell (anosmia) and taste (ageusia), with less common ones including headaches, nasal congestion and runny nose, muscle pain, sore throat, diarrhea, eye irritation, and toes swelling or turning purple, and in moderate to severe cases, breathing difficulties. COVID-19 was associated with approximately 3.4 million deaths worldwide. Treatments of COVID-19 have evolved over time. Initially, treatments focus on managing symptoms and maintaining organ function in severe cases. As humans have more knowledge about COVID-19, antiviral drugs are given to the patients. Later, a range of vaccines have been developed and distributed globally, which have proven effective at reducing severe illness, hospitalization, and deaths.
In the area of making diagnostics, medical science has indeed seen extraordinary progress over years. Diagnosis has been described as both a process and a classification scheme, or a “pre-existing set of categories agreed upon by the medical profession to designate a specific condition”. In many cases, diagnostic testing can identify a condition before it is clinically apparent; for example, coronary artery disease can be identified by an imaging study indicating the presence of coronary artery blockage even in the absence of symptoms. Martin Fischer, a Professor of Civil and Environmental Engineering and Computer Science at Stanford University, once said. “Diagnosis has had a large impact on how we identify and treat diseases.” An accurate medical diagnosis is the first critical step in patient care, and significantly improves the patient's overall chance for positive health outcomes. During the 14th century, the diagnosis of Bubonic Plague was largely based on clinical symptoms before the discovery of its cause, Yersinia pestis. Even though the bacterium was found, it took days to get lab confirmation. As for SARS in 2003, initially it was a challenge to identify the cause. Around late 2003, a real-time quantitative polymerase chain reaction (PCR) was established to detect and identify the SARS-associated coronavirus. When H1N1 spread in 2009, the existing PCR diagnostic tests were adapted to identify the virus for H1N1, and large-scale diagnostics were available relatively quickly. Medical professionals are sure about the virus of COVID-19 in 2020, enabling mass production of PCR tests. Later, antigen tests are developed to offer quick results. People could take the home test kits to make diagnosis of COVID-19 by themselves, further expanding diagnostic capabilities. Across these diseases, we can clearly see the ability to diagnose has become quicker and more accurate, demonstrating the advancement of medical science.
Additionally, medical professionals have made tremendous efforts in finding treatments to cure many diseases. Many bacterial infections that were once fatal are now treatable with antibiotics. Similarly, antiviral medications have been developed and improved to manage the diseases. Due to limited knowledge in the medical field, there were no effective treatments for the Bubonic Plague in the 14th century to be found. Similarly, there were no known effective treatments during the initial SARS outbreak in 2003. Doctors used supportive care or quarantine measures to passively treat this disease. Unlike SARS, the antiviral medications were developed to provide treatments for the H1N1 disease in 2009. COVID-19 presented a global challenge in 2020. At the beginning, doctors could not find specific treatments. Within a year, the treatments for COVID-19 progressed from supportive care to include antiviral drugs like remdesivir or monoclonal antibodies. Statistics data has proved the decrease of fatality rate due to advancement of medical science. The fatality rate of Bubonic Plague was extremely high and estimated to be about 50% to 60%. SARS had a fatality rate of around 10%. The H1N1 had a relatively fatality rate of less than 0.02% while COVID-19 is estimated to be somewhere around 1-2%. Although many people are infected with H1N1 or COVID-19, the deaths are relatively low, compared to other pandemics. Without questions, the treatment or medicine of medical science for the more recent diseases have helped in controlling the spread and reducing the fatality rate.
Speaking to vaccine development, medical science has equipped the capabilities to respond to new threats at an unparalleled speed. Vaccines help an individual’s immune system fight infections faster and more effectively. When an individual gets a vaccine, it sparks his immune response, helping the body fight off and remember the germ so it can attack it if the germ ever invades again. Since vaccines are made of very small amounts of weak or dead germs, they won’t make you sick. “We have to take care of the cure that will make the problem worse no matter what.”, Joe Biden, the president of the United States, once said. There was no vaccine being developed for the Bubonic Plague, suggesting no effective means of prevention back in the 14th century. Initially, no vaccine was created for SARS. However, medical professionals did begin to conduct the vaccine research later after the outbreak ended. After the cause of H1N1 in 2009 was identified, scientists developed a vaccine for preventing H1N1 just within months. The speed of vaccine development for COVID-19 was unprecedented. Two types of vaccines (mRNA vaccines and protein subunit vaccines) are developed, tested, and distributed within a year. Citizens have choices to take vaccines from Pfizer-BioNTech, Moderna, or Novavax, to protect against serious illness from COVID-19. Currently, 70.6 % of the world population has received at least one dose of a COVID-19 vaccine. 13.57 billion doses have been administered globally and 3120 are now administered each day. The quick development of vaccines and the rapid uptake of vaccines all reflect the advancements in medical science.
In conclusion, medical science has certainly advanced significantly in terms of making diagnostics, finding treatments, and developing vaccines since the time of Bubonic Plague. However, despite the advancements, challenges remain. Although nowadays medical professionals quickly invent diagnostic tests to identify the disease, maybe medical professionals could do more research on speeding up the time for seeing the results after taking the diagnostic tests or invent more continent or comfortable ways of diagnostic tests. Also, effective treatments are made to cure the patients who are infected with the disease, but access to medical care and treatments varies among different regions and different socioeconomic groups. Moreover, while vaccines can now be developed much more quickly, the response time can still be improved in order to keep up with the unexpected, fast-spreading diseases. At the same time, the authority or government should pay attention to the distribution of vaccines to make sure the equity in uptaking the vaccines.
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