Jan 29, 2020 3:23 PM

We Should Deescalate the War on the Coronavirus

Fear, finger-pointing, and militaristic action against the virus are unproductive. We may be better off adjusting to a new normal of periodic outbreaks.

The immediate reaction to the emergence of a novel coronavirus (2019-nCoV) in Wuhan, China, has focused on its challenges to the biomedical sciences. But the new infection is at least as big a challenge to the social sciences. If we continue to neglect this, there is a serious danger that we end up with mistaken national and international policies that do more harm than good.

Almost 30 years ago, Philip Strong, the founder of the sociological study of epidemic infectious diseases, observed that any new infection prompted three epidemics: of fear, then moralization, then action. Strong was writing in the context of HIV/AIDS, but he based his model on studies that went back to Europe’s Black Death in the 14th century . Whenever new infections emerged, the first response was invariably fear that they’d become an existential threat to humanity. We are all going to die. The second response was to see the outbreak as a verdict on human failings; divine judgement has gradually been replaced by political miscalculation. The third response was to engage in action, however pointless, intended to “do something” about the threat.

The responses to the coronavirus devoutly follow this pattern. At this stage, some eight weeks into the outbreak, there is still a good deal of uncertainty: A clear picture of the risks may not be available for another couple of weeks, when the virus’s incubation period and mode of transmission are better understood. However, it is already reasonably apparent that the virus is a relatively mild infection for most, potentially serious in a small proportion of cases and fatal in a few cases, particularly where the victim is already in poor health. Beyond the global fear, we are also seeing Strong’s second and third epidemics. International conservation and animal welfare organizations are using the outbreak to moralize about the traditional Chinese practice of eating a wider range of animal species than people of European heritage consider acceptable. Although wildlife markets are seen as a likely point for viruses to cross from animal to human hosts, as in Wuhan, they are a long-established part of Chinese food culture.

The outbreak is also the basis of a critique of the authoritarian nature of the Chinese state. Some of the online videos making implausible claims about infections and death rates are clearly being produced by political opponents to further their own agendas.

Then there are the demands for action—any action—to show that something is being done. The border health checks that have been introduced around the globe have at best a 20 percent chance of detecting an infected person. Face masks make little difference to the chances of picking up the infection in ordinary social interaction; the virus is so small that it goes through the fabric or round the edges.

As countless media outlets have characterized it, governments around the world have declared “war” on the coronavirus. China “battles the outbreak” (Al-Jazeera) of a “killer virus” (Daily Mail) “raging across” (CNBC) the country. The language of combat justifies measures of state security. Wuhan is in “lockdown” (BBC) as the authorities undertake the “screening from hell” (Foreign Policy) to “target” cases. The intrusive measures originally introduced to deter terrorism are supplemented by authoritarian interventions aimed at biosecurity, like compulsory temperature screening or internment in quarantine facilities. Within China, President Xi Jinping is concerned that the Party flag should "fly high at the frontline of the battleground" (China Daily).

Although it is still early for a definitive view, the challenge to governments and international organizations may not be the militaristic one of fighting a war against the virus but in helping people adjust to a “new normal.” Perhaps they should spend more time communicating that the coronavirus may be just another virus that will circulate in human populations for a number of years and that eventually there will be a vaccine and reasonably effective therapies. The coronavirus may be broadly comparable in risk to a bad seasonal influenza, or, at worst, the 1918 influenza pandemic. In the latter scenario, the number of deaths could run into millions, and we should not take that lightly. At the same time, the proportion of the population lost to deaths from 2019-nCoV would be relatively small. Moreover, the costs of disruption may well exceed the benefits. Quarantines and other preventive measures can create food and medicine shortages and depressed economic activity that result in many deaths. None of this is good news, but it is news that we should be able to live with.

As sociologists, we can help to understand this. As Strong pointed out, new infectious diseases disrupt our sense of order, trust, and stability. In fact, of course, they are out there all the time. Viruses do not distinguish between animals and humans. A random mutation that allows a virus to cross the species barrier, if it successfully adapts, simply enlarges the pool of potential hosts. Once established, further mutations are likely to stabilize the accommodation, generally in the direction of reducing the damage to the host. Natural selection works against mutations that kill the host before they can be passed on. These processes have been going on for as long as humans, animals, and viruses have coexisted and coevolved. We are simply noticing them more quickly, although increasing interactions between humans and wildlife, a result of pressures on habitats, are creating new opportunities for viruses to move between species. Such exchanges are, however, no different in principle from the risks of large-scale pig farming: Intensive biosecurity is as much to prevent the pigs acquiring viruses from humans as to protect humans from porcine viruses.

Humans deal very badly with the idea of chance and contingency. We lead increasingly ordered and regimented lives. We take stability for granted, assuming one day will be much the same as the next. Some natural events are common enough to have management plans that rapidly reimpose order on chaos: Hurricanes, tornadoes, floods, and blizzards may not be wholly predictable but occur frequently enough that we’ve developed largely predictable relief responses. New infectious diseases come out of the blue, each with its own idiosyncrasies that militate against detailed advance planning. Public health agencies take down a playbook from the last event and try to improvise around it. They are, though, constantly battling against the three societal epidemics and the expectations that nature can be boxed and controlled.

In the 1970s the cultural critic Ivan Illich identified medical hubris as a key problem for modern societies. Believing that nature could be bent to our will, we had forgotten how to live with nature, and that disease, disability, and death are part of the human condition. This does not mean we have to accept these challenges passively or that we should not seek to manage them, but we also have to understand that they are to some degree unavoidable. Newly emerging infections—HIV, Ebola, SARS, MERS, Zika, coronavirus—remind us of the limits of biomedical science. We have brought some under human control, but others continue to coexist with us, much as they have for millennia.

The problem with the coronavirus is that we are not yet absolutely sure whether it is more like SARS, highly contagious and lethal, or like seasonal influenza, contagious and unpleasant but rarely fatal. Right now it appears to be closer to influenza (which is from a different family of viruses). If this continues to be the case, then we must question whether waging a full-scale war on the disease is really the best thing to be doing. Military language encourages the illusion that we can bring evolution under human control: Wars are to be won. The risks of death or serious illness from the coronavirus currently seem to be broadly comparable to those that we accept every year as a result of influenza. It’s not desirable if you are in a vulnerable population group, but it’s better than total disruption of your usual health care in search of an unachievable victory. Would it be less damaging to social and economic life to accept that most people are quite likely to become mildly infected by the coronavirus, and that this will, in itself, reduce the possibilities for transmission as more people develop antibodies, and that biomedical science will eventually develop vaccines and therapies, much as happened with HIV?

Updated 2-4-2020 12:45pm EST: This story has been updated to clarify details about the coronavirus' comparable risks.

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