So here we are, essentially still in thrall to a coronavirus – with horrid terms like “social distancing” and “lockdown” having worked their way into the lexicon even as we are inundated with nauseating corporate platitudes along the lines of “we’re all in this together”. Then there’s “Zoom fatigue” and “brain fog”, giving us all an excuse to whinge about how tired we are. Which I, personally, enjoy a great deal as it gives me an excellent excuse not to do the things I don’t want to do.

Inevitably, as with most things health related, discourse has descended into a kind of bipolar idiocy: either you’re a virtuous human being who defers to “scientists” (who these people are or what their expertise is doesn’t seem to factor in), keeps their distance (leaping ostentatiously away if anyone gets anywhere close), dutifully wears a mask (even in the car, alone) – or you’re a conspiracy theory nutter roaming the streets and howling at the moon.

This, of course, isn’t new but it gained traction with social media some decade or so ago when anybody, anywhere, could find like-minded lunatics instantaneously. So discourse on anything even marginally ambiguous (which anything scientific inevitably is) now descends into the subtle dynamics of a nursery school spat: T’is! T’isn’t. T’is too! There are only two settings, right or wrong. (By the way, if you learned everything you needed to know in kindergarten, you’re an idiot. Get your GED.)

Trouble is, while binary codes seem to work OK in the digital world, they don’t work so well in the real one. And science, especially, doesn’t lend itself to this kind of thinking.

Computer language(s) rule?

Science isn’t some sort of “amorphous blob” (to quote British physicist Brian Cox, quoted in the BMJ on line). Science is dynamic, self-questioning and oftentimes wrong; it’s a method designed to grope for some measure of truth via empiricism.

With time, as the concepts become more refined, so do the answers. Which is how we moved from the notion of “miasmas” of bad air in sick rooms causing infectious disease to an understanding of microbes and germ theory. An understanding that continues to evolve. The development of better microscopes and laboratory techniques played a part as well, not to mention keen thinking by the likes of Pasteur and Koch. Later, a happy lab accident led to antibiotics and this daft idea we’ve formulated as a result that there’s a pill for every ill.

Science is not dogma and a great many hypotheses fall by the wayside. Just check the sheer number of un-reproduceable results for, say, genetics, if you don’t believe me. (One biotech company, Amigen, hoping to develop a miracle cancer drug, tried to replicate 53 “landmark” genetic studies – of which they were only able to replicate six. And they included the original researchers. But those other 47 trials undoubtedly made headlines in their day.)

The real strength of science is that it is self-correcting: it is not a religion or a deity or the final word.

By last March, alas, between the media shrieking blue bloody murder and epidemiologists insisting we were all going to die, it all built up to a crescendo of panic which has yet to subside. The zombie apocalypse would be upon us any minute. (Never mind that there aren’t a lot of good brains around these days for those poor zombies to eat.)

Now, months later, it seems to me, governments and policy wonks, epidemiologists and virologists, having scared the living daylights out of everyone, are a tad unclear as to what to do next. We’re tip-toeing into phase 3, with stores and such re-opening, but nobody’s all that clear about how close to get to that plexiglass or how essential those masks really are. I detect a hint of disquiet as the economy tanks and people are pushed into poverty all over the world, which every gibbon knows is what’s really bad for health.

Trouble is, once you’ve scared everyone half to death un-scaring them isn’t especially easy.

Freakout

For my part, I have wearily realized that this pandemic business was inevitable. The world was waiting for a pandemic, it was wanting a pandemic – and a pandemic is what it got. Now we’re stuck with the dregs and the aftermath.

There have been rumblings about the Next Great Plague for decades. There was SARS in 2003 (where under a thousand people died), then H1N1 (but then there was a vaccine) and its variants some years later. Each time the so called experts began their siren song, warning us that any second now, the plague was upon us.

It certainly didn’t help that popular culture, films, TV shows, have gone on incessantly about the dangers of microbes, be it bioterrorism, laboratory mismanagement or just bad luck. Every other day some actor strode about in in some show, unrecognizeable in a HazMat suit, looking suitably grave – even as virologists threatened us with the next “war” against some killer pathogen. (I recall a profile of some chap “hunting” viruses, profiled in The New Yorker, a la Indiana Jones, with your man chasing the virus that was going to kill us all.)

In short, we were primed.

The 1918 flu always held up as a template – millions dead and pandemonium in the streets, and boy will you be sorry you didn’t listen. Never mind that in 1918 they barely understood antisepsis, never mind antibiotics. Not to mention that pesky war to end all wars.

This time it took. First off there was that term, “coronavirus”: so easy to pronounce. (Quick reminder: the common cold is a coronavirus.) Plus, it originated in China, a country many of us have reservations about. Its genome was sequenced there making the provenance of this “novel” virus suitably creepy. At first it may even have seemed exciting, in a horror-movie sort of way. People do love to be scared, after all. And the word “pandemic”. So scary. Boo.

After that it took on a life of its own – and nobody took a breath, stopped to consider how focusing solely on a virus, using the most primitive medical model, could have dire, lateral, contextual consequences. Contrary to the idiocies posted on Facebook and its ilk, the reality of health is that it is not an either/or, zero sum game. Either we all wear our masks and keep our distance or everybody dies. Dodge any other human within several metres or the virus “wins”. Military metaphors sunk so deep within public health discourse and public consciousness we don’t even see they’re there. Just ignore the basic immunologic aspect: virus + organism could = disease. It’s not a given. Not just about the virus but the host. And not everyone with a virus will react to said virus.

People live in the real world, with real lives, and this freakout has had real consequences for work, housing, education, and health – which is about far more than an immune response to a virus. It was as though we forgot, watching the numbers rising at the edge of the screen that we all die, with or without a virus. In 2018 according to the World Economic Forum some 56 million people died. No coronavirus then, just, well, life. And flu and TB and a myriad other things. All made worse by deprivation and poverty and hopelessness and stress and all those other things.

To paraphrase Norman Bethune, there are two kinds of tuberculosis. The rich man’s TB and the poor man’s TB. The rich man gets better, the poor one dies. As we saw with this virus. The worse afflicted – other than the few whose immune systems responded with that oft-mentioned cytokine storm – were the poor, the marginalized, the malnourished, the warehoused. Sorry, but camping out at your holiday cottage, complaining of Zoom fatigue as you do your work on line, is not the same thing as losing the one (or three) poorly paid jobs you have which is all that’s keeping your family fed and housed. In the U.S. or Bangladesh.

Nobody likes to talk about the larger context; too complicated, so muddled, damn ambiguous, non-linear. Can’t be neatly graphed or displayed in bright colours. It isn’t something an infectious disease expert or virologist really knows much (or cares) about. It became about the virus; never mind the consequences of shutting it all down or how this will affect communities, cities, families, children.

Keeping it clean

Perhaps the one (semi) positive note I can see in all this is that perhaps some basics around hygiene we’ve appeared to have forgotten will get some attention. You know, things like keeping hospitals and schools and busses clean. Maybe we’ll remember that it’s a good idea to wash our hands more. Or hey, we could consider paying the people who take care of the elderly a living wage so they don’t need to work four jobs to make ends meet. Revolutionary concept.

Maybe we can revisit this notion that buildings need to be hermetically sealed, with no windows that open, giving some of us sick headaches. Or stop already with those horrid digital faucets that spurt water at random. That last one comes from personal experience (but I’m not bitter) from the times I tried to get my hands clean enough to take my contacts out on campus. But even though I brought a nail brush and soap from home, it never worked. I could never get enough water to scrub my hands properly. (Old joke: how do you know someone’s had to use a hand dryer in the washroom? Their trousers are wet.)

There’s a Danger Lurk!

There is simply no way to do away with risk. Risk is all around us. Nothing is 100% safe. Not crossing the street, or going to the dentist; no medical treatment, no drug, no surgery, nothing. It’s a risk to sit too much, stand too much; exercise too much, exercise too little.  You get my drift. (Incidentally, even though everybody’s all worried about a virus doesn’t mean bacteria aren’t still out there too.)

So here we are, singing the coronavirus blues, trying to figure out who decides what this “new normal” is, and watching people pander to their OCD tendencies, get all worked up about masks and otherwise indulge their inner Stasi. Hoping, I guess, that virtue trumps risk.

Trouble is, as the French philosopher Bernard-Henri Levy, who was pilloried for writing about the plight of the Rohingya in the age of coronavirus, has rightly said, our response to this virus has been more pathological than the virus itself. Aptly, he quotes Virchow: “An epidemic is a social phenomenon comprised of some medical aspects.” Not the other way round.