“It’s remarkable that bad things don’t happen more often. According to one estimate reported by Ed Yong in the Atlantic, the number of viruses in birds and mammals that have the potential to leap the species barrier and infect us may be as high as 800,000. That is a lot of potential danger.”
This past Christmas, my mother gave me Bill Bryson’s new book on the human body as a present. It was an excellent gift: I spent half my Christmas break totally absorbed in it. The book is fascinating for several reasons. For one, there is an awful lot that most of us do not know about our own bodies—which itself is funny to think about. But perhaps we are better off not knowing, since the book also highlights how many things could potentially go wrong in the intricate functioning of our mortal frames. The existence of life is a miracle in its own right; and the existence of highly complex life—such as us (or so we like to flatter ourselves)—is a miracle of exponential proportions. So many things have to go right in order for you and me to be here.
That means it is easy for things to go wrong. And a viral infection—when malicious genetic code hijacks our cells—is one way that this marvelous process can get disrupted. One of the best chapters in Bryson’s book is on diseases. When I read the chapter, not too long ago, it seemed to be mainly about things from the distant past that used to menace our species. Bryson discusses typhoid and typhus, smallpox and ebola, and of course the Spanish flu of 1918. Most of these illnesses strike us nowadays as historical curiosities, rendered obsolete by the invention of vaccines and effective antibiotics. But Bryson sounds a note of warning in the chapter that now seems quite prescient. He quotes Michael Kinch, a specialist on drug discovery of Washington University, as saying:
The fact is, we are really no better prepared for a bad outbreak than we were when Spanish flu killed tens of millions of people a hundred years ago. The reason we haven’t had another experience like that isn’t because we have been especially vigilant. It’s because we have been lucky.
I vividly remember reading that passage, and scoffing. Surely, I thought, we must be far better prepared than they were back in 1918, when medicine and technology were so comparatively primitive. I was wrong. Bryson deserves kudos for his writing, as this current crisis has completely borne out his warnings. We are in far more danger than we like to think, and we are basically not prepared for it.
One rather stunning fact—stunning because we so rarely think of it—is how many people normally die from the seasonal flu. In the United States alone, it is between 30-40,000 per year, and that number gets much bigger during particularly bad years. According to Bryson’s book, in the 2017-18 flu season, upwards of 80,000 people died of the flu. These numbers are stunning, especially considering the massive international response that is already underway to slow the spread of this new coronavirus, which has so far taken far fewer lives. Perhaps we should always be practising social distancing…
The primary issue, at the moment, is essentially this: our society was not built to handle large-scale infectious diseases with fatality rates significantly higher than the seasonal flu. We do not have enough hospital beds, nurses, doctors, respirators, masks, or anything else. Our entire way of life—hanging out in bars, going to concerts, flying from country to country—is premised on being largely free from dangerous infectious diseases. We really did not know how lucky we were. Our situation was highly anomalous in human history, and it will take months before we can return to it.
What is most frustrating, for me, is the degree to which the situation is out of my hands. Everyone craves a sense of control. In a crisis, we want to know what we can do to protect ourselves, or to contribute to a common cause. Right now, these actions are rather humble: wash your hands, stay at home as much as possible, self-isolate if you show symptoms. This is all well and good; but we naturally want to know what is the scale of the danger and how long this immense disruption will last.
At this point, the information available is far from clear. The more articles I read, the more contradictory the information seems. Some are predicting infection rates of up to 80% of the population, while others predict 20%. Some predict that the disease will turn out to be less deadly than it seems, while others are predicting a complete global disruption lasting for months. It also seems unclear (to me, at least) whether children are effective vectors of the virus. Judging from the school closures, many believe yes; but I also have read that there is little available evidence.
Our best tool in fighting pandemics are vaccines. But unfortunately vaccines can take quite a long time to develop. It is not as easy as I (naively) thought. Many trials must be performed to ensure that the vaccine is effective and safe for the general population, and this takes time: months and months. If we cannot immunize ourselves artificially, then, the only possibility is to develop a herd-immunity the hard way: by getting the disease itself. This is a frightening prospect. That route would entail a great deal of suffering and death. But how long can we wait in our homes? In short, I am unclear how we are going to get out of this mess.
Meanwhile, I am fairly stuck in my little apartment in Madrid, one of the new epicenters of the virus. We have only had three days of isolation, and it is not so bad thus far. I began an exercise routine that I can do in my room, and my brother and I have been cooking a lot of hearty meals. But I really cannot see how everyone will be able to keep this up for the long-term, either economically or psychologically. Without extraordinary government measures, I do not think that people could stay in their homes much longer than one month without a great many people facing serious financial strain. Even in the best case scenario, the consequences for the economy seem quite grave. And this is putting aside the social pressure to resume normal life, which will increase from day to day.
At present, I swerve wildly from optimism to pessimism. What I want most of all is a return to normalcy. Never has my old life seemed so desirable! The strangest thing about this crisis is that it went from trivial to serious so quickly. Everyone seems to have been caught unawares. But even Bill Bryson—a popular writer with no specialized training—was able to see potential danger once he looked into the research. If only our experts had been as intelligent and as anxious as he.