Comment by dredmorbius | Hacker News Reader

Comment by dredmorbius | Hacker News Reader

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Centralised latrines with waste diverted from freshwater supplies would be a net-net win over, say, backyard privvies which soaked directly into adjacent wells and surface streams. The latter was the case in cities such as London and New York well into the 19th, and early 20th, centuries. Keep in mind that the haulage of human waste itself ("night soil" in some cultures) was a major activity with its dedicated labour pool (pardon the mental image...), though that was in part based on social shunning of those who were so employed.

Concentrations of people create hygenic issues regardless. On balance, Romes latrines were probably a net benefit, though of course the Romans lacked modern understanding of disease, both in parasitic and infectious forms.

Even today, roughly 85% of the increase in human longevity, much due to decreased infant and child mortality, is attributable to general hygiene, municipal sanitation measures (both of wastes such as sewerage, solid rubbish, and of improved air quality; and of vastly improved water and food quality. Other public health measures, including quarantine, epidemiological surveillance, and vaccinations, also played a huge role. I first became aware of this through Laurie Garrett's book The Coming Plague (1994): <https://search.worldcat.org/title/30701925>

See "The Conquest of Pestilence in New York City" for a ... graphic ... expression of the trends in mortality from ~1800 through 2000 or so:

<https://1.bp.blogspot.com/-uTWEATUzgxk/TXQoTibILtI/AAAAAAAAA...>

> Even today, roughly 85% of the increase in human longevity, much due to decreased infant and child mortality, is attributable to general hygiene, municipal sanitation measures (both of wastes such as sewerage, solid rubbish, and of improved air quality; and of vastly improved water and food quality. Other public health measures, including quarantine, epidemiological surveillance, and vaccinations, also played a huge role.

Additionally, humanity gained a broad selection of antibiotics in the same time. Infections that used to be pretty deadly (e.g. syphilis, the plague) or debilitating (meningitis, ear infections, wound infections) are easily treatable. Even extremely deadly viral infections such as HIV or mildly deadly but highly contagious ones such as SARS-CoV-2 have symptomatic and suppression treatments.

The challenge is that bacteria evolved over the last 100-ish years just as well and a wide class of antibiotics are useless against some strains (e.g. e-coli) nowadays... and what used to be "reserve antibiotics" to be used only if a human's life was in danger is routinely fed to livestock to make it grow better, with the predictable result of resistance genes evolving in the livestock and mixing said resistance genes with bacteria prevalent in humans.

There's a reason I'd linked the NYC "pestilence" chart.

The first broad-spectrum antibiotic, penicillin, wasn't discovered until 1928, wasn't administered medically until 1930, and then still experimentally, and wasn't mass produced until near or after the end of WWII, with 2.3 million doses available the invasion of Normandy (Spring 1944) and nearly 650 billion units by June 1945). General availability to the US public didn't occur until 15 March 1945.

Yet if we look at the NYC mortality graph, mortality falls tremendously during the latter part of the 19th century and attains the level it sustained through most of the 20th century by 1920, well before penicillin was even first isolated, let alone applied broadly. If you compare against the date of penicillin general availability, mortality actually rises until about 1970, after which there is a plateau, followed by a comparatively sharp decline (though minor in context with the 1850--1920 decrease) after 1990.

Antibiotics are invisible on that chart.

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