Early in the pandemic, National Geographic published an article about Mary Mallon, the Irish immigrant dubbed “Typhoid Mary” by a New York City tabloid in the early 1900s. National Geographic tries to be non-political, so the article focused on Mary Mallon’s role in helping clarify for the public health profession the dangers posed by so-called “superspreaders” in disease outbreaks, explaining how investigators linked her to more than 50 cases of typhoid fever, even though she herself never became sick. If we needed more evidence of the power of super spreaders, early in the Covid pandemic, a so-called super spreader event at a Boston hotel sponsored by the biotech company Biogen likely launched the spread of Covid to as many as 300,000 people.
I’ve been thinking more about Typhoid Mary over the last few months, as Covid has not only persisted in our lives, but has morphed into an ever-more abrasive political issue, with any number of states enacting prohibitions on actions that could limit super spreaders (or even regular spreaders), like requirements to wear masks, engage in testing, and even to become vaccinated. In the days of Mary Mallon, it would have been totally astounding to have major political leaders, like the governor of Florida, going to court to prevent schools from requiring their students to wear masks while in school at a time when children are getting sick from a pandemic at ever-increasing rates.
When you review the case of Mary Mallon, you realize how far we’ve transitioned as a society from focusing on protecting the health of the community at large to abandoning such protections in the interests of some strange idea of personal “freedom.”
Mary Mallon worked as a cook in wealthy New York households in the late 1800s and early 1900s, It took a lot of careful investigating by New York City public health authorities to link her with the transmission of 54 cases of typhoid fever, even though she never became ill herself.
When the public health authorities finally made the case that she was the cause of many serious illnesses, Mallon reacted something like the moms who show up at school committee meetings today and berate and threaten officials who want to require that students and teaches wear masks. According to the National Geographic article, a public health sleuth found Mallon in the Park Avenue household where she was the cook, “When confronted with his evidence and a request for urine and feces samples, she surged at (the investigator) with a carving fork.” Had there been an internet in those days, we might have heard her try to blame 1G or 2G wireless for making people sick, or possibly a conspiracy from the Austro-Hungarian empire, or maybe all the new horseless carriages showing up on New York’s streets. Millions of ordinary people would have become instant experts on the origin of typhoid and its treatments.
Mallon kept moving around as investigators closed in on her. “Finally, Mallon was escorted by (a public health investigator) and five policemen to a hospital where—after a nearly successful escape attempt—she tested positive as a carrier for Salmonella typhi, a bacteria that causes typhoid. This would later be confirmed by more tests. She was quarantined in a small house on the grounds of Riverside Hospital. The facility was isolated on North Brother Island, a tiny speck of land off the Bronx.”
Mallon fought her enforced quarantine as a violation of due process and went all the way to the U.S. Supreme Court. But according to National Geographic, she lost when the court refused to hear her case, saying “it must protect the community against a recurrence of spreading the disease,” The city would release her in 1910, on condition she not work as a cook. But she never could earn the same money doing other household chores, so she went back to cooking, under phony names. When she was connected to an outbreak of typhoid involving 25 people in a maternity hospital in 1915, she was sent back into forced quarantine, this time for the remaining 23 years of her life. When she died in 1938, nine people attended her funeral.
Even public health officials realized after their encounters with her that the penalties against Mary were a tad extreme, and the practice of locking super spreaders or sick people on isolated islands transitioned during the time she was kept forcibly isolated, into voluntary isolation at home. Today, of course, even that is seen as akin to capital punishment by some in our society, for whom it’s unthinkable to even demand that people in public or private settings wear masks to reduce the spread of Covid.
But isn’t it in reality a sign of respect for those around us when we decide to wear masks or get vaccinated? I found myself reacting that way yesterday when I was arranging for a utility repair person to come to my house to update some equipment. “Have you and others in your household been vaccinated?” asked the utility rep on chat. For just a moment, I pushed back mentally about the very personal question, but then I answered, “Yes.” After all, I wanted that repair person to encounter as little risk as possible coming into my home. As it turned out, the utility would still have sent a repair person, because the next question asked: “If anyone hasn’t been vaccinated, are you willing to wear a mask and keep at least six feet” from the repair person? Once again, I answered affirmative.
I have the same attitude about going into supermarkets, big box stores, and sending children to schools. Everyone who is exposing themselves to public contact—especially the cashiers and stock workers and teachers– deserves the respect of the public in the interests of avoiding Covid. What is so difficult to embrace about such basic principles of decency and respect for the community you live in? Unfortunately, we have moved so far in the opposite direction, of damn the community, that I suspect Typhoid Mary might today be viewed in certain areas of the country as a freedom fighter, and those attempting to look after the community at large as communists.