DEAR READERS: A pandemic is defined as “an epidemic occurring worldwide, or over a very wide area, crossing international boundaries and usually affecting a large number of people” (“A Dictionary of Epidemiology,” Oxford University Press, 2001). So clearly, international cooperation is vital in helping identify, monitor and prevent the spread of highly infectious diseases from country to country.

But now the United States is withdrawing from the one international organization where many American specialists are employed: the World Health Organization. On July 8, the U.S. formally notified the United Nations that it is withdrawing from the WHO. Global-health experts warn that the move puts at risk everything from polio eradication to pandemic preparedness. Much is uncertain: The WHO’s founding constitution has no provision for countries to withdraw.

“This is the end of an era of United States global-health leadership,” says public-health legal scholar Lawrence Gostin. (Read more at nature.com in the article “What a U.S. exit from the WHO means for COVID-19 and global health.”) Such isolationism is wrong-minded, putting not only American citizens at risk, but people in other countries -- as well as animals wild and domestic, which may become infected with, or be reservoirs for, pandemic diseases.

The British social critic George Orwell, in his seminal book “Nineteen Eighty-Four,” coined the term “doublethink” as a process of indoctrination whereby the subject is expected to accept as true that which is clearly false, or to simultaneously accept two mutually contradictory beliefs as correct -- often in contradiction of one’s own memories or sense of reality.

One illustration of doublethink is President Trump’s repeated assertion that if we had fewer COVID-19 tests being done, there would be fewer cases. The truth is that the cases exist, whether they are documented or not. The failure of the U.S. government to stop this pandemic cannot be papered over by obfuscation, doublethink and promises of soon-to-come vaccines. Trump’s assertion that 99% of coronavirus cases are “harmless” ignores the fact that asymptomatic people can infect and kill others, especially those with preexisting conditions.

DEAR DR. FOX: I had an animal rescue for 15 years. In addition to doing adoptions and caring for unadoptable critters, I also advised pet owners. People often asked the question about how to know when it’s time to say goodbye. Here’s how I would answer: ”Consider whether your pet is still living the life of (a dog, a cat, a rabbit, whatever). Get a little calendar and every day, mark whether your pet is having a good day, a bad day or a so-so day. When there are more bad days than good days, it’s time.”

People find this comforting. It gives them something they can measure. Another advantage of the calendar is that it helps prevent the “Was it too soon?” second-guessing that torments people. They can look back at the calendar and remind themselves that it was the right time. -- P.B., Memphis, Tennessee

DEAR P.B.: I think your advice will be helpful to many people who may otherwise have regrets and feel guilty having their animal companion euthanized. Keeping a record of daily quality of life can help avoid memory-suppression of bad days, which is part of our own self-protection from the burden of empathy and remembering just how long an animal had been suffering. Desensitization to how much an animal is suffering day after day might then be avoided.

DOGS AT RISK FROM TOXIC LAKES

With climate change, ponds and lakes across the U.S. are warming up, creating ideal conditions for algae to flourish. Of special concern is blue-green algae called Cyanobacteria, which produces a toxin lethal to dogs, and probably wildlife, who drink the water. It can also make people ill if it gets into their water supply. Runoff from fertilized lawns, gardens and agricultural crops, along with farmed animal manure, feed the algae, creating toxic blooms. Scientists are finding nutrients (as well as microplastics) in windborne dust precipitating over remote lakes where algal blooms are being reported.

Keep your dog out of the water if you have no assurance that it is safe, and if your dog does go for an off-leash dunk -- water-loving breeds like Labradors in particular -- hose your dog down thoroughly when you get home. Also, never let your dog drink from standing water. Take water and a bowl with you if you are going for a long walk or hike.

(Send all mail to animaldocfox@gmail.com or to Dr. Michael Fox in care of Andrews McMeel Syndication, 1130 Walnut St., Kansas City, MO 64106. The volume of mail received prohibits personal replies, but questions and comments of general interest will be discussed in future columns.

Visit Dr. Fox’s website at DrFoxOneHealth.com.)

DEAR DR. FOX: How dare you bring religion into how we treat animals? Last paragraph from a recent column: “For atheists and agnostics, there can be no denying that other animals possess intelligence ...” You added the comma, making this sentence represent the calling out of atheists and agnostics as people who do NOT see animals as worthy. I am agnostic, and I believe all creatures deserve life and freedom. I believe animals possess intelligence. You corralled me into a group yet you know nothing about me.

That is how I read your article. Guaranteed, I am not the only one. If you did not mean it that way, then apologize to your readers. Whether we “agnostics and atheists” deny your god has nothing to do with how we perceive and treat our pets and family members. I have been agnostic for a lifetime and I spoil my pets like angels, and yet I see “God-fearing Christians” beat their pets.

I hope you print this, as you are showing your white privilege and your white ignorance. Religion ONLY belongs in a church. -- K.P., Naples, Florida

DEAR K.P.: I am responding to your letter, firstly because you imply that I am displaying “white privilege” and “white ignorance” in my newspaper column by bringing religion into how we treat animals. That is a curious criticism, but understandable, as the “virus” of racism infects and clouds our thinking. For any misunderstanding in my communications, I apologize.

The core teachings of all the world’s major religions, as I document in my book “The Boundless Circle: Caring for Creatures and Creation,” is obeying the Golden Rule: treating others, including fellow creatures, as we would have them treat us. That has nothing to do with the color of my skin, but with the light of compassion and maitri -- loving-kindness toward all beings, which Gautama Buddha proclaimed is the only true religion. I would think atheists and agnostics would embrace this, since Buddhism is atheistic. Secular humanists may be as limited by anthropocentrism as monotheists are in their belief in a male god figure who only created man in his own image.

By all accounts, spirituality needs to be rescued from religions that have, arguably, done more harm than good to man and beast alike for millennia.

Theists, atheists and agnostics alike can surely agree that all lives matter, and that it is time to recover our humanity for the sake of the environment and all life on this beautiful planet.

They say beauty is in the eye of the beholder, but when we let what is natural around us touch our spirits, we awaken to the Spirit of Life and feel and breathe the light of creation. Birdwatchers and nature photographers and artists know all about that. But when we awaken to the unnatural around us -- the electrified cities, polluting industries, cruel animal factory farms, impoverished communities and malnourished millions -- we may begin to feel and breathe the truth of why we are such a sickened and sickening species. And with the spirituality of religious teachings -- or the nonreligious bioethics of justice and respect for all life -- begins the great healing that is long overdue.

DEAR DR. FOX: Our dog has a lump on her neck after wearing a Seresto collar for quite a while. We are afraid it may be cancerous. Please advise. -- R.H., Chincoteague, Virginia

DEAR R.H.: I am sorry to hear about your dog’s swelling on the neck, which calls for an immediate veterinary examination. Many veterinary hospitals are open for business, but you may not be allowed into the facility during this pandemic. A staffer will come and take your dog from your vehicle for examination. Be sure to wear a mask, and bring your cellphone to communicate with the veterinarian while remaining in your vehicle.

My fear is that your dog has a form of cancer called lymphoma, but there is the off-chance that this is a nonmalignant lipoma -- a fatty tumor -- or chronic inflammation from a bite or thorn. Do let me know the veterinarian’s diagnosis and treatment.

I wish everyone, including veterinarians, would think twice about putting an insecticide-releasing collar around dogs’ and cats’ necks. We would never do it to our children. For details about the harmful consequences of this incredible stupidity, read my critical analysis “Companion Animal Risks of Flea and Tick Insecticides” on my website (drfoxonehealth.com). I also have a step-by-step approach to preventing fleas and ticks in companion animals posted there.

(Send all mail to animaldocfox@gmail.com or to Dr. Michael Fox in care of Andrews McMeel Syndication, 1130 Walnut St., Kansas City, MO 64106. The volume of mail received prohibits personal replies, but questions and comments of general interest will be discussed in future columns.

Visit Dr. Fox’s website at DrFoxOneHealth.com.)

DEAR READERS: In a report in the May 13 New England Journal of Medicine, on the topic of the transmission of SARS-CoV-2 in domestic cats, Peter J. Halfmann, Ph.D. et al. state:

“With reports of transmission of SARS-CoV-2 from humans to domestic cats and to tigers and lions at the Bronx Zoo, coupled with our data showing the ease of transmission between domestic cats, there is a public health need to recognize and further investigate the potential chain of human–cat–human transmission. This is of particular importance given the potential for SARS-CoV-2 transmission between family members in households with cats while living under shelter-in-place orders. In 2016, an H7N2 influenza outbreak in New York City cat shelters highlighted the public health implications of cat-to-human transmission to workers in animal shelters. Moreover, cats may be a silent intermediate host of SARS-CoV-2 because infected cats may not show any appreciable symptoms that might be recognized by their owners. The Centers for Disease Control and Prevention has issued guidelines for pet owners regarding SARS-CoV-2 (www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/animals.html). Given the need to stop the coronavirus pandemic through various mechanisms, including breaking transmission chains, a better understanding of the role cats may play in the transmission of SARS-CoV-2 to humans is needed.”

As we fight COVID-19, the Animal Legal Defense Fund published a white paper with law and policy recommendations to prepare for and prevent the next pandemic. See also a Cambridge University report by William Sutherland and associates (https://www.cam.ac.uk/research/news/study-identifies-275-ways-to-reduce-spread-of-coronavirus-following-lockdown), stated that shutting down China’s live animal markets was not enough. The study also highlights how pandemic diseases can jump from animals to humans, and offers 275 ways to mitigate future crises -- from going vegan to limiting livestock production and consumption.

DEAR DR. FOX: Our 6-year-old shorthaired cat stopped eating two weeks ago. She became very lethargic, and she has started hiding and stopped grooming. She is urinating fine, but producing very little poop. She is drinking water.

We took her to the emergency room for cats. Her heart, lungs and eyes were all good and clear. They gave her mirtazapine and Cerenia. She did have a spike in her food intake for about a day and a half, and also ate a few pebbles of Iams dry food here and there.

But as of today, she ate about two bites yesterday and nothing today. We have tried many different flavors and brands, both wet and dry, plus real tuna and salmon. I grated Parmesan cheese on her food, used chicken broth, warmed her food, etc. She goes to the food immediately, smells it, then walks away, meowing.

As seniors, money is an issue and we just can’t afford unlimited medical care. We are wondering what advice you have for our precious baby. -- V.T & J.T., Brick, New Jersey

DEAR V.T. & J.T.: I understand your predicament, since more tests are likely in order -- at least abdominal palpation, as well as an X-ray or sonogram to see if there is a fur-ball filling the stomach, or a lymphoma tumor. She could have one or more tooth abscesses or another oral health problem that makes eating very painful. Such abscesses would also make her body toxic with infection and inflammation -- what I call the oral plague of cats.

Perhaps you can discuss a payment plan with the veterinary hospital. A cat who is not eating can get serious health complications within just a few days. It is good that she is drinking. Try adding some mushed-up canned sardines, or offering her some meaty or fishy Gerber baby food.

Keep me posted, and good luck!

TICK CONTROL, SURVEILLANCE LACKING IN U.S.

The number of tick-borne illnesses reported in the U.S. more than doubled from 2004 to 2018, according to the CDC, but fewer than half of the nation’s public health and vector-control agencies have active tick surveillance programs. Just 12% conduct or fund tick-control programs, researchers reported in the Journal of Medical Entomology. “Pathogen testing is an essential component of surveillance, and is needed in order to understand tick-borne disease risk to communities,” said lead author Emily Mader, who manages the Northeast Regional Center for Excellence in Vector-Borne Diseases at Cornell University.

Our state and federal government agencies need better funding for these programs -- now more than ever, with climate change-related increases in insect-borne diseases.

KANSAS CONFIRMS VSV IN HORSES AT PRIVATE PROPERTIES

Kansas became the fourth state this year with confirmed vesicular stomatitis virus cases when the virus was found in horses at several private properties in the south-central part of the state. VSV is transmitted primarily by black flies, sand flies and midges. Owners of horses, cattle, goats, sheep, llamas and other susceptible animals should be diligent about preventing flies and other insects from thriving where animals are housed. (Hutchinson News, Kansas, June 17)

(Send all mail to animaldocfox@gmail.com or to Dr. Michael Fox in care of Andrews McMeel Syndication, 1130 Walnut St., Kansas City, MO 64106. The volume of mail received prohibits personal replies, but questions and comments of general interest will be discussed in future columns.

Visit Dr. Fox’s website at DrFoxOneHealth.com.)