You have probably heard of a disease called cholera. It’s a water-borne bacterial infection, originating in India in the second decade of the 1800s, and it has caused seven pandemics so far, killing millions of people – especially in the first six pandemics, which occurred between 1816 and 1923. The seventh one has been ongoing since 1961, but you may not be aware of it, because it is mostly happening in so-called developing countries. Why is it no longer laying waste to industrialised countries?

Part of the reason was vaccination, as one of the first immunisations for cholera was developed by the famous Louis Pasteur, and the bacterium involved (Vibrio cholerae) was identified in the late 19th century. But the main reason was the understanding that this disease is spread where there are crowded living conditions and poor sanitation. To this day, it rears its ugly head when water supplies have been contaminated due to war or natural disaster, but it is not something we, here in affluent North America, generally need to be concerned about. Why is that?

The 1854 Broad Street cholera outbreak in London ended after the physician John Snow identified a neighborhood Broad Street pump as contaminated and convinced officials to remove its handle to prevent people from drawing water there. His study proved contaminated water was the main agent spreading cholera, although he did not identify the contaminant. It would take many years for this message to be believed and fully acted upon, but eventually, governments were forced to take action.

In the late 19th and early 20th centuries, cities in North America and Europe undertook major sanitation projects, building sewer systems and water purification plants. People came to expect their drinking water to be safe – here in Canada, many First Nations reserves live under boil water advisories, meaning that their drinking water is not safe, and that is considered a shameful thing, to be remedied as soon as possible. 

Why don’t we feel the same way about the air we share?

SARS-Cov-2 is only the latest in airborne diseases to kill millions of people – the 1918 flu pandemic led to improved ventilation. If, like me, you live in a house that was built in the aftermath of that terrible time, you will have big, heavy radiators under windows that open. The idea was that the windows could be kept open in the winter, because the radiators would be blasting enough heat to keep the house reasonably warm. Of course, it’s a terrible waste of energy, and after the oil crisis in the seventies, insulation and air-tight houses became the norm. Ventilation took a back seat, and we are paying the price for that now.

With modern technology, we can have well-ventilated houses, offices and public spaces, without sacrificing energy efficiency, but we have to be willing to spend money up front on HEPA filters and good air exchange. To do that, we have to care about the quality of our air as much as we do about the quality of our drinking water. Who will be our John Snow?

In the meantime, well-fitting respirator masks and air purifiers are available at a reasonable cost to help keep us from infecting each other with an airborne disease that has killed millions and continues to cause heart attacks, strokes and diabetes. We expect our sewers and water treatment systems keep us from infecting each other with waterborne disease, and we can do the same with our air. We just have to decide it’s important. As a bonus, it will help protect vulnerable people from the effects of wildfire smoke, too.

What do you think? Should we, as a society, invest in better quality air for everyone?