Measles as a best-case study of how humans stack up to respiratory viruses?

by philg

Nearly two years ago, when public health officials first began talking about “science” in the context of the measures they were taking that would eradicate SARS-CoV-2, the medical school professors whom I know would point out that humans had never beaten a respiratory virus and therefore there was no possible scientific basis for a confident belief that a proposed intervention would be effective.

Influenza is a familiar example of respiratory virus that has laughed at our science and medicine. The common cold viruses are another class that are apparently smarter than us. Measles is a unique case. It has a bizarre-for-an-organism inability to mutate. “Why you need one vaccine for measles and many for the flu” (ScienceDaily, 2015):

The surface proteins that the measles virus uses to enter cells are ineffective if they suffer any mutation, meaning that any changes to the virus come at a major cost.

It’s only possible to speculate why the measles virus would find an evolutionary advantage to being so rigid, but one hypothesis is that measles uses a more complex strategy to get into human cells than influenza. Influenza, for instance, simply requires the binding of one of the sugars that decorate the outside of cells as a means of getting inside. In contrast, measles requires binding to specific cellular protein receptors as its doorway.

Since measles can’t mutate, we have great drugs for treating it and near-100 percent vaccine coverage all over the world, right? Wrong. In fact, measles kills roughly 200,000 people per year (WHO). They’re mostly under the age of 5 so they would have lived at least 50 more years, even in the poorest countries. That’s 10 million life-years lost every year to measles.

How does losing 10 million life-years compared to the killing done by COVID-19? WHO says that 1.8 million humans were killed by COVID-19 in 2020. Unless each one had another 5.6 years to live, which seems unlikely given that the typical victim in Massachusetts was 82 with comorbidities, measles actually took away more life-years than COVID-19. And if we use the British technocrats’ quality-adjusted life year, measles was far more destructive than COVID-19. Measles prevents people from enjoying their healthiest and most vigorous years while COVID-19 chops off the years during which electric scooters are required for mobility.

(The above paragraph raises the obvious question of why hardly anyone in the EU or US cared about measles deaths prior to 2020 or, even now. Nobody would have been willing to spent $10 trillion to save 10 million high quality life-years destroyed by measles.)

Because it is free to mutate, SARS-CoV-2 is a much more elusive enemy than Measles morbillivirus, yet I think our definition of success against COVID-19 is much more stringent than the standard we’ve applied to ourselves when fighting measles. Unless humans have become vastly more capable in just the past year or two, aren’t we setting ourselves up for disappointment?

7 thoughts on “Measles as a best-case study of how humans stack up to respiratory viruses?”

  1. I think there’s a lot of sunk cost thinking going on. The previous SARS was nipped in the bud before it became endemic, and I think a lot of people latched onto that as their mental model (like the places that still have zero covid policies), and won’t let go of that alternate reality, despite the fact that we can’t get back there.
    The narrative says that it didn’t happen because of deplorable politicians and deplorable anti-vaxxers (you still hear palpable anger against the unvaxxed as “plague rats” in blue zones, despite the fact that covid is now endemic in deer, etc), and they’re all going to make it as painful as possible so we all pay. We’re basically grounded because we were bad.

    • SuperMike: I’m sure that you’re right, but it is strange that Americans who blame the American Deplorables aren’t able to reflect that there aren’t any European nations that kept COVID-19 out, despite a wide variety of policies and often high compliance levels. If it had been a realistic possibility to nip COVID-19 in the bud, wouldn’t the Swiss, for example, have done it? It is tough to think of a country that has a more favorable combination of cleanliness and pharma.

    • @philg: you’re saying this has to make sense? The is 1984 “Eurasia has always been at war with eastasia” stuff. These are the same people that believe that the 2020 race riots didn’t cause a single case, but the Sturgis motorcycle rally caused 70,000. They will sometimes point to New Zealand or Australia, ignoring the fact that those are island nations without huge permeable land borders and global commerce links.
      It’s essentially religious: the nonbelievers didn’t follow the sacraments and have brought down this plague upon us.

  2. The notorious Moshe Feiglin’s (former MK) rather amusing diatribe (sounds as if he is talking about MA):

    “A whole country is stuck in isolation and in queues for testing without any need. Children are unoccupied away from school and restless in their homes, parents are unemployed. Independents look on with disappointment at the collapse of their businesses. Youths are getting addicted to alcohol and drugs. The percentage of suicides is skyrocketing. Families are falling apart. The economy is on the verge of collapse and the health of citizens is continuing to deteriorate.

    “Complete insanity for nothing. Simply nothing,” Feiglin wrote on Facebook.

    “Our neighbors in Gaza are in a much better situation simply because they don’t have an advanced health ministry like we do.”

    Feiglin added, “If I were prime minister, I would announce, starting from this moment, that all instructions are canceled and like the dust of the earth. Use of a mask in the public sphere would be forbidden because it aids in nothing but instilling terror and fear. I would immediately destroy the entire Israeli reserve of injections. I would make sure that efficient medicines like ivermectin and hydroxychloroquine were within arm’s reach of every citizen.”

    “Finally, I would establish an independent commission of inquiry to investigate the crimes of the heads of the health ministry, who caused the state of Israel to deteriorate into such an insane and pathetic situation without any need at all.”

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