Tomatoes are incredibly susceptible at the genetic level.
Carol Deppe writes about what she thinks needs done about that in her book The Tao of Vegetable
Gardening. If you look at her website she is looking for funding for tomato breeding. Basically for us to continue into the future with heirloom tomatoes breeding in multiple resistance to late blight is probably necessary. That's just one disease.
The source of the disease resistance genes are the wild species. There are roughly 13 species of tomatoes not one. So while the one domestic species is susceptible, the species complex is genetically robust. In fact some of the species are obligate out breeders much as is tomatillo. This is important because outbreeding species of tomato are massively more diverse at the genetic level than are inbreeding species.
Joseph Lofthouse has proposed a solution that
should permanently change the susceptibility of domestic tomatoes. Breed the obligate out breeding system into them. We are several years into this effort and it's been very interesting. I've been growing the resulting hybrids in my garden. Mostly hard unpalatable green berries like the wild parents. However, Joseph has already gotten tasty ones, and I think I will this year. So more years of work needed but it seems possible.
Gardeners in humid, warm, and moist climates are most susceptible to tomato diseases. Some areas are infested more than others. Much of Europe has multi strain and thus breeding late blight and thus has overwintering spores. Eastern states tend to have more problems than arid western states. I agree that probably where this guy lives everything he does is necessary. Garden size matters too. I have a large garden on a small acreage where if it wasn't all involved in tomato breeding I could really move tomato plants far each year. Someone with a tiny garden in susceptible and infested area might need to be really careful. Or skip years.
I am fortunate to live in the arid west in a valley where tomato and solanaceae diseases are rare. Farmers raise seed potatoes here for that reason. My garden seems to do pretty well with growing tomatoes year after year and I just rototill the vines in.
So smart some places. Sometimes a gardener will move across the country and continue with now unnecessary practices, so paranoid is also possible after experiencing the trauma of tomato death at some point on your
gardening career.