Bedside Rounds 58 - The Original (Antigenic) Sin
Oct 26, 2020
Tony Breu, a practicing internist and co-host of The Curious Clinicians, delves into the intersection of health and race, tracing historical pandemics like yellow fever and polio to reveal enduring health disparities. He discusses the impact of social determinants on COVID-19 outcomes, particularly among Black and Native American communities. Breu also critiques the concept of 'original antigenic sin' and immunity passports, linking past inequities to contemporary challenges in healthcare. His insights shed light on the urgent need for systemic change in medical practices.
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Pandemic Exposed Deep Health Inequities
- COVID-19 revealed stark racial disparities in hospitalization and mortality in the U.S., especially among Black and Native American communities.
- The speakers link these gaps to social determinants of health rather than innate biological differences.
Old Medical Ideas Shaped Racialized Medicine
- Historical medical ideas tied environment and social context to disease long before modern terms like 'social determinants of health.'
- Early frameworks like humoralism and diathesis morphed into scientific racism and influenced disease explanations.
Acclimation Became Social Capital In New Orleans
- New Orleans suffered repeated yellow fever waves with extraordinary mortality, especially among recent immigrants.
- Locals developed 'acclimation' where surviving yellow fever conferred social and economic advantages.