Upstairs into the Plague

I was driving into work this morning and I hit the traffic jam. Every morning at about 6:30 am the traffic begins to back up on the highway leading into my medical center. It’s the morning shift — hundreds of nurses and clerks and aides and orderlies and housekeepers bleary-eyed and guzzling Starbucks and they wait to enter the parking garage and begin their (usually 12 hour) shift. I avoid the crush and go in the back way. It’s a bit of a walk but I need the exercise. 

When I got into the office, our team was waiting to make rounds. Several of them were on call overnight — they spent the night in the ER, seeing neurosurgery patients, amidst the crush of humanity with fevers and coughs. I’m lucky — I’m the professor, and I mostly go to the operating room — where it’s sterile and everyone wears masks. My team in the ER doesn’t have that luxury. They don’t complain. 

I worry about them. For their health, of course, but also because we really need them. Most of the neurosurgery emergency care for our very large county is provided by our department, and if our people get sick, a couple of million people will have difficulty getting care. We’re trying very hard to stay healthy in this COVID-19 pandemic, and to keep working and keep informed. 

Treat Coronavirus with Darwinian Theory?

The media is full of talking heads and experts. They’re mostly doing their best, but the ideologues and grifters are all too plentiful.  To wit, we get lots of “reminders” about the importance of evolutionary science and Darwin in the management of the coronavirus pandemic. 

• “Geneticist Spencer Wells on COVID-19 as ‘Evolution in Action’”
• “Biology | Basic evolution knowledge could have helped China control coronavirus”
• “Evolution of an outbreak”
• “Coronavirus — we need to learn from Darwin”

There’s no doubt that COVID-19 evolved: populations of viruses change with time. Of course, we know that from epidemiology and virology and simple observation. Darwin’s theory has little to do with epidemiology. Darwin proposed that all biological adaptation and speciation arose from wholly unintelligent processes. Given the ubiquitous evidence for intelligence in nature, this atheist biology was a tough sell without a mechanism by which the stunning tapestry of information-bearing life came about. In an epiphany, Darwin hit upon the explanation for life — survivors survived! Atheists at last were intellectually satisfied.

Darwin’s actual impact on epidemiology is minimal — his theory (published in 1859) mainly served to distract scientists and doctors from the real science on infectious disease that emerged from the work of Girolamo Fracastoro (16th-century physician who proposed that infections were caused by microorganisms), Antonie van Leeuwenhoek (17th century — discovered microorganisms), Thomas Sydenham (studied London epidemics in the 17th century), Edward Jenner (first smallpox vaccine — 1757)), Ignaz Semmelweis (discovered in 1847 that antisepsis prevented post-partum infections), John Snow (stopped cholera epidemic in London, 1854), Louis Pasteur (germ theory of disease), Joseph Lister (antiseptic surgery), Robert Koch (modern bacteriology), Paul Ehrlich (Nobel laureate who cured syphilis), Alexander Flemming (penicillin), Jonas Salk (polio vaccine), to name just a few. 

Fascinated by Barnacles

Darwin, who was mathematically illiterate and fascinated by barnacles, flunked out of medical school, married his (wealthy) first cousin, wrote a book on the origin of species by natural selection in which he provided no evidence for the origin of species by natural selection, and worked sporadically, mostly from bed. He would have required remedial training to get a job cleaning Pasteur’s test tubes. Yet his contribution to atheism, unlike his contribution to science, was epochal. 

A “Narrative Gloss”

Epidemiology, to which Darwinism is a “narrative gloss,” is an old and vigorous science. But there’s more to the amelioration of epidemics than superb science. The most important advance in preventing epidemics — probably more important than vaccinations and the gamut of 21st-century high-tech science — is low-tech public sanitation. There is probably nothing (except for food and water and blankets) that has saved more lives from epidemics than enforcement of the principle that drinking water and sewage water must not be the same water. And low-tech medical care is indispensable as well. Historian Rodney Stark points out that survival in epidemics is often more the consequence of ordinary courageous people who stick around and do their jobs than it is of sophisticated medical technology. This was the reason that Christian communities in antiquity had much higher survival rates than pagan communities during epidemics. Christians would stick around — at risk to themselves — and would not flee and abandon plague victims to die of starvation or exposure. The most effective medical care in a plague is someone who gives a damn. 

Of course many modern scientists are doing good vital work in this pandemic. Kudos to the virologists and epidemiologists and critical care specialists who are working hard to save lives. We need to understand virology and develop anti-viral medications and develop strategies to “flatten the curve” of the pandemic. But to those politicians and science grifters who would use this catastrophe for partisanship or ideology, give it a break. Spin and evolutionary tautologies are just a pandemic of an intellectual sort. 

Running Toward Danger

What we need right now is captured in an image from 9-11 — this coronavirus pandemic reminds me of that time. It’s a picture of a fireman in Tower 1 running up stairs, when everybody was running down. You could see in his face that he knew what he was facing. He had no illusions. There are people who run towards things like that. 

Every night, when most of us have put away our favorite novel and switched off our remote classroom link on our university-bought computer and done our last wipe with Purell before bed, the midnight-shift stock boys at Shop Rite will begin restocking the shelves with toilet paper and food, working through the night in aisles trodden by thousands of panicked (and a few febrile) shoppers. In the hospital the housekeepers on the 11-7 shift will clean patients’ rooms, scrubbing walls and toilets that the rest of us wouldn’t touch without a hazmat suit. And the nurses on the night shift will wipe the mucous and hold the hand of someone’s grandmother who is gasping for breath in the ICU. 

Every stock boy or housekeeper or nurse is doing more to fight this pandemic than all the politicians and talking-head science grifters and tenure-track professors in the department of Organismic and Evolutionary Biology at Harvard. And more than all the neurosurgery professors, too. 

So say a prayer, whether evolutionary biologists like it or not. Pray for the stock boys and the housekeepers and the nurses. Pray for the people on the front line — the people waiting in line at the hospital parking garage at 6:30 am. 

Pray for the people running into this plague when everyone else is running away.