Soap and Water & Common Sense: The Definitive Guide to Viruses, Bacteria, Parasites, and Disease
By Dr. Bonnie Henry
House of Anansi, 2009
Dr. Bonnie Henry’s news conferences have become a part of daily life in B.C. When they attend her briefings, Premier John Horgan, Health Minister Adrian Dix and Public Safety Minister Mike Farnworth fade into the background, at a safe distance from her and one another. They speak chiefly to endorse what their chief medical officer says. The contrast with Trump’s press conferences is impossible to miss.
It certainly helps that Dr. Henry can deliver alarming news in a calm tone of voice, without relying on technical jargon; we pay attention, we absorb the news, but we don’t freak out. Treated like adults, we respond like adults.
Those same communication skills are evident throughout her 2009 book Soap and Water & Common Sense, written years before she became B.C.’s provincial health officer. The book is now available with a new introduction, written in March, and the content itself is still very timely: while our health-care system is fighting COVID-19, other diseases are going to exploit their opportunity.
Henry offers a short history of our battles with infectious diseases, using a witty metaphor: “Welcome to the awe-inspiring world of Microbes, Inc., a global corporation that has dominated our planet for three billion years.” She then takes us on a tour of company headquarters and its divisions: viruses, bacteria, fungi and parasites. We meet viruses that do indeed go viral, like smallpox (now mercifully retired), influenza, SARS, HIV and Ebola.
The bacteria division is another big profit centre. Despite the successes of antibiotics, bacteria’s ability to mutate has enabled the rise of “superbugs,” resistant to almost every antibiotic we can throw at them. We’ve only made life easier for bugs like staphylococcus and streptococcus by using antibiotics where they’re useless, like colds. Eventually we could find ourselves back in the pre-penicillin age, when any cut or scratch could be fatal.
Dr. Henry takes us through each vast division of Microbes, Inc., including airborne, waterborne and foodborne bugs. Implicit in her description is a critique of our global mass production of food: “In our search for cheap, tasty and nutritional sources of sustenance combined with our insatiable desire for fresh seasonal foods all year round, we have created increasingly complex and wide-reaching networks that have allowed bugs to thrive and to spread globally.”
She points out that “Listeria was virtually unknown before the production of ready-to-eat foods. The first recorded outbreak of the disease was in Halifax, Nova Scotia, in 1981. Forty-one people, mostly pregnant women and children, became ill, and 18 died from the disease.” The source: mass-produced coleslaw made from cabbage tainted with sheep manure. The most recent outbreak in Canada lasted from August to November 2019, and affected B.C., Manitoba and Ontario.
International trade includes the export and import of such diseases. Dr. Henry cites the case of Sweden, which had kept salmonella out of its chickens and eggs for decades — until the Swedes joined the European Union and began importing chicken from EU countries with less rigorous standards.
Cheap air travel also has its hazards: In 2005, Dr. Henry tells us, 10 French hunters went bear-hunting in northern Quebec. They killed a black bear and barbecued its meat, and ate it cooked medium or medium rare. Two took bear meat home to share with family and friends. All told, 14 of the hunters and their friends came down with trichinellosis, caused by the parasite trichinella.
Good budgeting equals bad hygiene
Dr. Henry doesn’t exempt her own profession. Superbugs have found happy homes in countless hospitals around the world, including Canada. One of the nastiest is methicillin-resistant staphylococcus aureus, or MRSA, which causes thousands of deaths every year in Canadian and American hospitals and nursing homes. Eradicating such superbugs is possible, but expensive. Canadian health-care systems, meanwhile, have been underfunded for years; outsourcing hospital cleaning is good budgeting but bad hygiene.
Even cost-conscious hospital design can put patients at risk. As Dr. Henry says, “In some ways it is hard to believe that we place the most vulnerable people in hospital rooms with three or four others who may also suffer from contagious disease, and even ask them to share a washroom.” Single-room facilities, she argues, would actually save money (and lives) in the long run.
Throughout the book, Henry writes clearly and concisely; a 12-year-old could follow her explanations. This is a rare talent among health professionals. Her narrative is full of surprising facts and bits of history: I had no idea that the Iditarod races commemorate a dramatic effort to get antitoxin across Alaska in January 1925 by dog-sled relay to save 25 children in Nome who were dying of diphtheria.
Similarly, I was unaware that Canada was involved in an early test of the 1950s polio vaccine that seemed to show the vaccine was actually giving kids polio. Paul Martin Senior, the health minister of the day, was himself a polio survivor as was his son, a future prime minister. Martin ordered the test to continue, and the problem was later traced to an American lab that had accidentally contaminated a batch of vaccine with live virus.
Dr. Henry’s book is a compendium of microbial horrors that persist into the COVID-19 era and could well benefit from it: pandemics tend to cause more collateral damage than to those who succumb to the disease itself. In the West Africa Ebola outbreak of 2014-16, more people died of measles and other health problems than from the Ebola that made hospitals no-go zones.
My sole criticism of the book is that, apart from the introduction, it seems to be unchanged from the 2009 edition. So we learn about the start of the H1N1 “swine flu” pandemic, but not about its outcome. Since Dr. Henry was very involved with that outbreak, more about it would have been welcome. But now I’m looking forward to the book she’ll have to write about COVID-19.
Microbes continue to invade us the way we invade new ecosystems, and for the same reasons: to feed, multiply and expand still more. So for all our drugs and vaccines, one of our best preventive strategies remains good old soap and water — and, when we can find it, common sense.