A social event in New York is something that cannot be missed. It's an integral part of living in the city enabling the opportunity to show off the latest fashion, taste the always exciting menu and bar offerings and experience an atmosphere that is somewhat less stressful than the day to day hustle and bustle. It's also a relatively more intimate setting where people can share their stories, passions and ambitions with others.
It's also the perfect setting to share germs.
I had the opportunity to attend one of these events glamorized in film and the entertainment media and was honestly surprised at the number of people who had some kind of infectious complication. Some were obvious, such as the coughs associated with respiratory illness and the classic red, watery eyes of an adenovirus infection while others were a little more subtle, such as the wafting aroma associated with a gastrointestinal problem. But none of these signs seemed to stop the endless handshaking, cheek-kissing and close talking.
I was so intrigued by this apparent disconnect between health and social status that I had to ask one of the many people I met that night, New York Life blogger Sasha Davidoff, about the New York perspective on germs and the fact that at these parties, infections may be spread as quickly as business cards and email addresses.
"Germs are common in New York City, not just at parties, but in offices, trains, restaurants and the streets. People sneeze and sniff everywhere. But germs can't stop New Yorkers from going out. After all, everything is done in the span of a New York Minute and if you take time to sneeze, you may miss out or worse, be left out."
From a public health perspective, this is a complete rejection of the standard advice given when one is sick. For years, the rules of increased hygiene, covering up coughs and sneezes, avoidance of sharing cutlery and dishes, social distancing and staying home have been preached to prevent the spread of germs such as the common cold and the flu, yet New Yorkers seem to have either forgotten or ignored them. I asked Sasha about this quandary and she offered some perspective on why people risk their health in order to keep up with the Samantha Joneses.
"There is always a deadline, and you don't want to take the risk of being away for an instant, because you might be passed over in the future on interesting projects. Being sick could honestly jeopardize your career. It's the same with parties and other events. If you pass on an invitation, you may never get another. It's better to say that you've got a little cold, but will be okay than to not be there and not be seen or heard. Besides, two or three glasses of wine at those events would probably help to get rid of the symptoms, or at least the questions."
Sasha's words do not represent a contravention of common sense, however, but an understanding of how germs have lost their place as a major factor in social behaviour. Back in the 19th and early 20th Centuries, infection was often a matter of life or death. Lethal diseases such as cholera, yellow fever, smallpox and typhoid fever ravaged New York and led to hundreds of deaths. In 1866, the Metropolitan Board of Health developed the world's first sanitary code in order to mandate hygiene in the community. The rules were so stringent on the maintenance of hygiene in the population that it was deemed mandatory to report to the board any knowledge of any individual sick of any contagious disease including their condition and dwelling place.
Over the last few decades, thanks in part to modern medicine, vaccination and an increase in the cleanliness of the urban environment, the rules have become more relaxed. There have still been epidemics, such as drug-resistant tuberculosis and the more recent bedbug invasion which may lead to increased MRSA infections. But these headline grabbers have rarely resulted in immediate deaths. The end result has been a gradual but significant attenuation of the emotional and behaviour-changing impact of infection.
Today, the situation has reached the other extreme. Due to the loss of the threat of a quick and agonizing death, the fear of a germy demise has been vanquished.
For those working to increase awareness of health and hygiene, this reality presents an difficult conundrum. The centuries of hard work to lessen the impact of germs on human health has worked so well that hygiene itself has been overtaken by other more social concerns, such as a loss of career objectives or the potential for a red carpet photo shoot. Yet just around the corner lies another wave of potentially life-changing germs, such as the now well-known MRSA and C. difficile, as well as returning threats such as measles and polio. The public's attention must return to the realization that germs may pose a possible threat to health.
As Sasha suggests, it won't be easy.
"I think sickness today has a different definition for New Yorkers. Everyone is almost always either a little sick, or tired, or under the weather such that we don't even notice it anymore. If someone gets the flu or some other kind of germ, the whole community will eventually get it. They'll recover, and probably get it again. It's a cycle that we've become used to and that we accept."
In order to get germs back into the 21st Century mindset, a new direction has to be found; one that doesn't rely on rules and regulations but on the impact of illness on each individual and the culture in general. Considering the international focus on New York, there may be no better place to start.
Perhaps it's time to finally make that pitch for Germs in the City.