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What keeps me up at night?

Glad you asked.

If you have been a long-time reader of this blog, you might think that what keeps me up at night is the anti-vaccine movement that is so pervasive in this country. They don’t keep me up at night. You might even think that it’s a doctoral student in epidemiology who is one year removed from their PhD and is blatantly anti-vaccine. They and the harm they may inflict on public health also don’t keep me up at night. Heck, you might think that it’s the Orioles melting down in a spectacular fashion this season, or whether or not Mexico make it to the World Cup in soccer.

None of that keeps me up at night.

What keeps me up at night is this and scenes like it the world over:

"Al-Haram mosque - Flickr - Al Jazeera English" by Al Jazeera English - Al-Haram mosque. Licensed under CC BY-SA 2.0 via Commons -

“Al-Haram mosque – Flickr – Al Jazeera English” by Al Jazeera English – Al-Haram mosque. Licensed under CC BY-SA 2.0 via Commons

That right there, ladies and gentlemen, is the Al-Haram mosque during the annual pilgrimage of the Hajj. It keeps me up at night because of the number of people gathering at one place at one time. This kind of situation is ripe with opportunities for bad things to happen. From an outbreak of an infectious disease to a terrorist attack, public gatherings this big and this important keep me up at night because — for whatever reason — I’ve been “programmed” to think of worst-case scenarios when it comes to public health.

I won’t tell you what I’m thinking when I see these big gatherings because I don’t want to give anyone any ideas, but I bet you can come up with some messed-up scenarios in your mind that could really make a mess of things the world over.

And it’s not just the Hajj that gives me bad dreams. We have plenty of similarly-sized events here in the United States, like the Super Bowl or the Presidential Inauguration.

Super Bowl Parade, via Dave Sizer on Flickr, CC by 2.0

Super Bowl Parade, via Dave Sizer on Flickr, CC by 2.0

Also, cities are not getting any smaller. More and more people the world over are moving into cities, straining whatever resources are available. That’s kind of why we have the Ebola situation in West Africa right now. A lot of people in urban centers are encroaching on natural habitats of the likeliest of hosts for the virus: bats. And then a lot of the infected people are having a lot of contact with a lot of other people.

So crowded places with people traveling to and from them from different parts of the world keep me up at night wondering what will happen next, what will be the next pandemic, and what can I and other epidemiologists dream up to detect it early and counter it. In fact, in a few weeks, I’ll be heading to Minnesota for a conference on how to use new technologies to keep track of influenza, a killer in its own right. Technology is growing by leaps and bounds, and we still have a hard time using it to counter some very serious threats. It’s time to change that.

That’s what keeps me up at night. Again, thanks for asking.

Categories: Blog

Tagged as:

René F. Najera, DrPH

I'm a Doctor of Public Health, having studied at the Johns Hopkins University Bloomberg School of Public Health.
All opinions are my own and in no way represent anyone else or any of the organizations for which I work.
About History of Vaccines: I am the editor of the History of Vaccines site, a project of the College of Physicians of Philadelphia. Please read the About page on the site for more information.
About Epidemiological: I am the sole contributor to Epidemiological, my personal blog to discuss all sorts of issues. It also has an About page you should check out.

4 replies

  1. The nightmare that keeps me up at night is global air travel and a novel pathogen that is Influenza or Smallpox virulent.

    BTW, still in the Baltimore area, working toward relocation.
    Currently doing the 4 to midnight shift, but on the 11th, I’ll be doing a midnight to eight shift this month.
    I’m typically self-aware around 2. 😉


  2. Nice photo of both of Seattle’s major sports stadiums and its main train station. There is a reason to avoid that area, it is very difficult to leave. For a short time the Seattle Skeptics Meetup were in a bar about one building to the right of the train station and north by a block. It was too crowded and noisy on evenings when there were Seattle Sounders soccer (real football) games.


  3. Well I saw a picture of that first building in the news today. It is being expanded, and one of cranes fell due to winds and over a hundred people died. Large crowds, lots construction equipment, and high winds. That is what can keep certain structural engineers awake. Le sigh.


    1. That was the Grand Mosque in Mecca. It’s the central gathering point during the Hajj, a required pilgrimage for those able to travel and able to afford the pilgrimage.
      The Saudi Ministry of Health has ordered that no camels are to be sacrificed, screening at the airport and along the path of the Hajj will be conducted as well. The camel sacrifice prohibition due to real concerns over MERS-CoV and the latter, the usual concern over other communicable diseases.

      I wouldn’t want to be in public health in Saudi during the Hajj for all of the money in the world.


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