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INFECTIOUS
DISEASES

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doesn't have a party or an ideology.
In the case of infectious disease, we should do the same, perhaps with even
more urgency and more hope. Potential epidemics are sensitive to human re-
sponse. If the response is quick and effective, the disease can be contained. If
the response is lacking, the result may be an actual epidemic, with rates of trans-
mission and spread that are exponential.
Infectious diseases have been major actors in the course of human history.
Words like plague, smallpox, consumption, and pestilence strike a deep fear inside
us. We like to think of those diseases as something of the past. We feel protected
by modern sanitation, vaccines, and antibiotics. But inside us that fear remains.
There are a few things we can do with that fear. We can suppress it and hope
for the best. We can be its victim and jump from crisis to crisis, developing ad
hoc responses and finding scapegoats when the responses fall short. Or we
can put the fear to good use and think constructively and with foresight about
how to manage future threats.

David Lakey, MD, is associate vice chancellor for population health and chief medical officer
for The University of Texas System. He served as commissioner of the Texas Department of
State Health Services during 2007–15.

26 San Antonio Medicine • May 2018