After hearing that the Spanish government had named their response to the COVID-19 pandemic “Operación Balmis” after the Balmis Expedition of the early 1800s, I decided that my own personal response to the pandemic had to have its own name. The Balmis expedition was an expedition headed by Javier Balmis, the royal surgeon to the King of Spain in the early 1800s. As Jenner’s discovery of the smallpox vaccine became widely known, the King decided that his subjects in the Americas and in the Philippines were going to be free from the scourge of smallpox. He read Jenner’s papers and those of a French physician validating Jenner’s findings. So he entrusted Dr. Balmis to head the expedition and bring the vaccine to what is now Latin America and the Caribbean.
After a long deliberation on what to name my personal efforts in the Pandemic, I decided to name it Operation Onesimus. Onesimus was an African slave who was forcefully brought to the American Colonies in the early 1700s. At that time, there was no vaccine against smallpox. The disease just came around time after time and would take the lives of hundreds or even thousands of people. There was not much beyond social distancing that the people could do. By the time they realized they had an epidemic on their hands, many people had been exposed and would be sick. Many of them would die.
Onesimus was bought by Cotton Mather, a clergyman from the Massachusetts Colony. Reverend Mather, if you remember, had been involved in the Salem Witch Trials. As one epidemic of smallpox went through Boston and the countryside near it, Mather noticed that Onesimus was immune to the disease. He also notices that Onesimus was bright, seemingly education. Mather asked Onesimus about his immunity, and Onesimus pointed to his arm.
For centuries, people who wanted to be immune to smallpox would ask to be variolated. Variolation is the process by which the smallpox disease (variola) would be given to people in a controlled manner and under the supervision of a physician. The process usually included taking some of the pus from a person with smallpox and injecting it into the arm of a healthy person. The person would then develop a milder form of smallpox and then recover and be immune. Some people would get the full-blown disease, especially since there was no knowledge of how much pus with smallpox was too much. (We know now of things such as viral dose.)
Onesimus had been variolated when he lived in Africa. It is believed that the Arab traders who ventured into the sub-Saharan part of the continent brought the practice with them. When people found out that variolation prevented smallpox, they went along with it. Onesimus had been one such person, and that is why he survived so many smallpox epidemics in Massachusetts. He told all this to Mather, and Mather consulted with physician friends about it. After much deliberation, Mather and his physician friend decided to give it a try. After successfully receiving the variolation procedure, Mather and his family — and the family of the physician who went along with the plan — were spared from yet another wave of smallpox that went through the colonies.
This was not without consequences for Mather, though. What is perhaps the first anti-vaccine group formed around him and even firebombed his house. They claimed that he had given in to “African witchcraft” by taking the advice of a slave. Mather didn’t relent. He recommended the practice to other people in the colonies and in the British Empire. By the time the Americans decided to revolt, variolation proved to be key to defeating the British… But that is for some other time.
I decided to call my efforts “Operation Onesimus” because I decided to use the knowledge and wisdom of others throughout the generations to guide what I was doing. From John Snow’s crazy idea to map cases of cholera to understand its spread to my Hopkins professors’ lessons on epidemiology and public health, I was going to use everything and anything to try to make a dent in what is going on. And it would not matter to me if the naysayers were incredulous of my efforts. I was going to use all that to do well and try very hard to save my own corner of the universe, even if I didn’t do it.
As the pandemic has evolved, however, I’ve decided to change the name of my efforts to a new name… But that is for a later post at a later time. For now, it’s time for sleep, because sleep is at a premium right now.
Stay safe out there… We’ll get through this.
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.
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