One thing that people don't seem to understand is that effective infectious disease control has *always* involved what seem like harsh, draconian measures, especially for airborne disease. Many of us have just simply not experienced these kinds of controls on this scale.

I learned most of this from my own experience with active tuberculosis. From the moment I was diagnosed, it was like I had stepped into a new world I did not know existed. I had to be quarantined. I had no choice of doctor. I had no choice of treatment.

My freedom was immediately restricted by the state. If I refused treatment or quarantine, I could have been not only fined, but prosecuted. During my initial quarantine, health workers would randomly show up at my house to make sure I hadn't broken the rules.

TB also poses the additional issue of developing drug resistance. People in the past have not always adhered to drug treatment, for a # of reasons. You have to take at least 4 antibiotics. These cause rashes, fatigue, nausea, and peripheral neuropathy. The drugs are unpleasant.

There is also the risk of liver & kidney damage, as well as a risk of color blindness. One of the primary drugs turns all of your bodily fluids-including your tears-orange. You lose sensation in your fingers, which is combatted w/ vitamin B. I developed serotonin poisoning.

I still had no choice but to adhere to treatment protocol (which I was always happy to do, but others are not). And I wasn't allowed to touch the drugs myself, a healthcare worker would come to my house everyday, unwrap the pills, and check my mouth to make sure I swallowed them.

After I was out of quarantine, I wasnt allowed to leave the country. If I left the city, or I had to make contact w/ a diff local health department, go there, & have them watch me take the pills. I spent a friend's wedding lying on the floor in a closet b/c the meds were too much

There was also the contact investigation, which was a painful, humiliating experience. Every person I had been in contact w/ for two years had to be tested. Health workers hung out at the bars/restaurants I went to and set up testing stations. They tested all of my professors.

*This* is the reality of disease control. And, as awful as it was, it was necessary for it to be this harsh, because many people do not want to adhere to necessary protocols. It's a big reason why TB is largely under control in this country.

This reality has always existed. It's just been unseen to many of us, because we've never encountered it on this scale. And it's necessary.

Some pictures from TB land: 1) Daily pills x 7 months. 2) Loss of circulation from drugs. 3) Weekly sample collection. 4) My beloved healthcare worker & me on my last day of treatment.

(Side note: she was an HRC supporter & I was for Bernie. She called me her "other daughter")

Oh, and as Katie Porter brilliantly demonstrated in Congress: testing/treatment for airborne infectious diseases has often been *free* for patients. Of course the considerations are diff w/ COVID/TB in terms of treatment, but, overall, this structure exists & should be utilized

And, P.S. I wasn't always happy w/ the health department (specifically one of my doctors), but the nurses and other healthcare workers were all amazing. I developed a really strong relationship w/ my main healthcare worker. Wouldn't have made it through w/out her.