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Illness and disease

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The wisdom of pandemics

Viruses are active agents, existing within rich lifeworlds. A safe future depends on understanding this evolutionary story

David Waltner-Toews

Photo by Paul Zinken/dpa-Zentralbild/ZB/Getty

David Waltner-Toews

is a Canadian veterinary epidemiologist. His books include Food, Sex and Salmonella (2008), The Origin of Feces (2013), Eat the Beetles! (2017) and On Pandemics (2020). He lives in Ontario.

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Wisdom is the ability to discern inner qualities and subtle relationships, then translate them into what others recognise as good judgment. If it comes to us at all, wisdom is the product of reflection, time and experience. A person might achieve wisdom after decades; a community after centuries; a culture after millennia. Modern human beings as a species? We’re getting there, and pandemics can help. If we persist in our curiosity and reflect on what we find, and if we survive the waves of disease to come, the wisdom of pandemics will come to us. Perhaps as soon as a few centuries from now.

Pandemics are both deeply immediate and empirically long-lasting, symbolised by the Greek gods of time, including the unbounded Aion and the temporal Chronos, who ruled over past, present and future. Although we’re improving our abilities to understand each aspect separately, the challenge is bringing them together. Consider, for instance, the protracted history and arc of the 2020 pandemic caused by the coronavirus SARS-CoV-2.

In 1887, as part of its invasion of what is now Eritrea in the Horn of Africa, Italy shipped cattle over from India to feed its troops. Some of those cattle were carrying the virus that causes rinderpest, known historically among Europeans as cattle plague. The virus attacks even-toed ungulates, and is nearly always fatal. Informed by the mythology framing human relationships with disease in terms of war, the British tried to stop the spread of rinderpest with fences and guns. A decade later, the virus had swept through the immunologically naive populations of sub-Saharan Africa, killing almost 90 per cent of all the cattle, as well as oxen, sheep, buffalo, wildebeest and giraffes.

Rinderpest was successfully eradicated, worldwide, in 2011, primarily using that peaceful tool called vaccination. Nevertheless, its impacts continued.

In the wake of the initial devastation in Africa, few animals were left to herd, to plough fields or to hunt; a third of the people in Ethiopia, and two-thirds of the Maasai, starved to death. With the loss of grazing animals, the landscape was invaded and colonised by thorn bush. This provided poor feed for cattle, but excellent habitat for tsetse flies, which transmit trypanosomes, the single-celled parasites that cause animal and human sleeping sickness. Mortality from sleeping sickness rose dramatically.

In his landmark studies, the Soviet zoologist Yevgeny Pavlovsky described the ways in which human pathogens, particularly those of animal origin, are embedded in the ecological webs of particular landscapes; writing in 1966, he called this embeddedness ‘the natural nidality of transmissible disease’. In sub-Saharan Africa, for instance, trypanosomes were not the only tiny organisms whose nidality included cycling between local arthropods and mammals. The African swine fever virus (ASFV) had also for centuries passed between soft-bodied ticks and wild pigs, though without causing much discomfort in either.

In any event, after losing their livestock to rinderpest, British colonists imported large numbers of domestic pigs from the Seychelles and England. The pigs were raised freerange. This solution to a food problem through importation was followed, not long afterwards, by outbreaks of African swine fever (ASF) in the domestic pigs, in which the disease is almost always fatal. Over the next century, sporadic outbreaks were reported not only in Africa, but in various European and Caribbean countries. In each instance, the disease was controlled by killing all the pigs on farms where the disease was diagnosed. In 2020, there is still no treatment and no vaccine.

In 2018, ASFV appeared in Southeast and East Asia, including China. Chinese investigators suggested that the virus came from Russia. Russia asserted that the virus probably arrived in China through pork products from the European Union, or perhaps from somewhere in Africa. Whatever its source, ASFV, which persists in pork products, feeds and in the environment, spread rapidly across the country. Over the next two years, half the pigs in China – more than 200 million – died or were killed to stamp out ASF.

In the lead up to Chinese New Year, tens of millions of Chinese people were shopping for meat to celebrate the end of the lunar Year of the Pig and launch of the Year of the Rat.

With pigs in short supply, the entrepreneurial market vendors at Huanan Seafood Market in Wuhan were reportedly ready with meat from other species, including peacocks, wild rabbits, snakes, deer, crocodiles, turkeys, swans, kangaroos, squirrels, snails, foxes, pheasants, civets, ostriches, camels, cicadas, frogs, roosters, doves, centipedes, hedgehogs and goats. It is from this chaotic mix of colonial invasions and naive, semiregulated global trade that, in late 2019, SARS-CoV-2 (the virus) and COVID-19 (the disease) emerged.

A few months later, in the midst of the COVID-19 pandemic, the impact of the 19th-century colonial invasion into Africa came full circle. Measles virus had emerged as a mutation from the rinderpest virus somewhere between 500 BC and 1000 CE (the exact date being in dispute). Like rinderpest, measles is preventable through vaccination, and is similarly vulnerable to eradication. In 2020, even as politicians and public health officials in the Democratic Republic of Congo (DRC) struggled to respond to the new COVID-19 pandemic, they were faced with what one might call ‘The Son of Rinderpest’. In 2019 and 2020, almost 7,000 people in the DRC died of measles.

SARS-CoV-2 is a novel virus, but the story of its emergence is not novel. Similar narratives can be told of bubonic plague, cholera, yellow fever, Ebola and many others. From these, one can learn how to respond more effectively to the next pandemic – physical distancing, use of masks, testing and diagnosing, tracing, vaccinating if possible, isolating if not. This is necessary. But beyond tactical and technical lessons, or jeremiads about colonial history, is there wisdom to be gained?

Yes, if we open our minds. We don’t usually associate the intellectually ‘soft’ idea of wisdom with the ‘hard’ ideas of natural science. This sharp demarcation between science and understanding is by design. In the 17th century, in the midst of devastating religious wars, René Descartes wrote a Discourse on Method, a set of guidelines designed to enable people to explore and understand the physical world in a deeper way. He argued that ‘there being but one truth for each thing, anyone who finds it knows as much as one can know about that thing’ and that, in approaching complex problems, he found it useful ‘to divide each of the difficulties I examined into as many parts as possible and as required in order to resolve them better.’ His advice formed the basis for much of what we know, and celebrate, about what Thomas Kuhn in 1962 called ‘normal science’.

In this tradition, when attempting to understand pandemics, most research scholars and practitioners focus on the immediately observable details. In the midst of a catastrophic outbreak of disease, when one is looking for clues to enable effective prevention and control, this focus is understandable and necessary.

The Cartesian approach has brought us to the stage where we can quickly and efficiently study all the ‘things’ that make up a pandemic – organisms, species, genomes, viral structures, biological characteristics of those people or animals who are infected and die, and those who are infected and live. This is important for designing tests, public health protocols, vaccines and pharmaceutical treatments. For the long-term struggle to acquire wisdom, however, a single-minded, thing-focused science offers little help.

Faced with the complex social and ecological interactions from which pandemics emerge, many ‘normal scientists’, like the Auditors in Terry Pratchett’s novel Thief of Time (2001), are stymied. The Auditors, having broken down great paintings into their constituent molecules, are unable to understand why people respond to art with such deep feelings. Faced with pandemics, we – like Pratchett’s Auditors – can only declare, somewhat lamely, that pandemics are caused by novel viruses, that is, that ‘we have discovered a new thing under the Sun’.

Bubonic plague has now emigrated and made itself at home around the world. This is also true of SARS-CoV-2

In an interview in May 2020, the physician Ali Khan, former director of the Office of Public Health Preparedness and Response at the US Centers for Disease Control and Prevention, was asked what had gone ‘so disastrously’ wrong with the global response to COVID-19. ‘Was it a lack of scientific information, or a lack of money?’ asked the interviewer.

‘This is about lack of imagination,’ Khan replied.

Khan’s reply seems wise, but also unsatisfying. What is it – apart from science fiction dystopias – that we might imagine? Historically, wisdom emerges within particular cultures, and is often associated with elders and sages who have long-lived experience of how to survive, and thrive, in particular places. Pavlovky’s observations on the ‘natural nidality’ of diseases fit into this perspective.

In the 21st century, our understanding of pandemics challenges and alters this traditional view of natural nidality. Bubonic plague, once quietly circulating among marmots and fleas in the Mongolian steppe, has now emigrated and made itself at home around the world. This is also true, now, of ASFV and SARS-CoV-2, which most of us will have to find ways to accommodate.

If we attempt to carry traditional notions of wisdom across cultural and temporal borders, from wise individuals in communities and wise elders in local cultures, and bring, for instance the wisdom of ‘the East’, or of ‘the ancients’ (perhaps the Greeks), to 21st-century Europe or North America, we’re often left with a handful of commonplace, well-worn aphorisms, variations on themes of ‘everything is connected to everything else’ or ‘think globally, act locally’.

If the natural niduses of pandemics are now scattered around the whole world, is there a wisdom equal to the task? As Khan implies, normal science is insufficient to offer us guidance for how to move from conventional, local knowledge, to grappling with such globally complex, wicked problems. Can pandemics themselves be a source of wisdom, offering insights into how we might embrace normal, thing-focused science, and yet see beyond it to the inner qualities and relationships among things?

Some authors have used grand narratives, weaving together humanities and natural sciences, to offer insights into the origins and impacts of pandemic diseases. Hans Zinsser’s Rats, Lice and History (1935) and William McNeill’s Plagues and Peoples (1976) explored the social and biological causes of pandemics and speculated about their influence on human evolution and history. Jared Diamond’s Guns, Germs, and Steel (1997) went a step beyond this, giving epidemic diseases a central role in his revision of human migrations and animal domestication from prehistoric times to the present. In this tradition, Walter Scheidel in The Great Leveler (2017) argued that catastrophic epidemics were one of the few events – along with mass-mobilisation warfare, violent revolutions and state collapse – sufficiently powerful to flatten disparities in income and wealth.

What has been marginalised in these narratives, as well as in natural and medical sciences in general, is an understanding of the patterns of relationships and, for lack of a better word, ‘conversations’, that hold the world together and from which pandemics emerge. These nested, world-embracing conversations are expressed through chemicals, magnetic forces, broad spectrums of radiation, gravity, small and weak nuclear forces, mycelia, visible and invisible ecological webs.

The usual narratives have, if not a common language, at least an assumption that we have reliable ways to translate, across all the interacting, nested scales, between the many perspectives and conversations around us. Digging deeply into unbounded time, physicists have suggested that mathematics be considered a protolanguage, a Rosetta Stone or Babel fish to translate among the many languages in the Universe. We might learn a great deal about pandemics through mathematical modelling, but even the physicist Stephen Hawking, were he alive, would admit we have fallen short. Writing in A Brief History of Time (1988), he asked:

What is it that breathes fire into the equations and makes a universe for them to describe? … Why does the Universe go to all the bother of existing? … if we do discover a complete theory, it should in time be understandable in broad principle by everyone, not just a few scientists. Then we shall all, philosophers, scientists, and just ordinary people, be able to take part in the discussion of the question of why it is that we and the universe exist.

But what if the very notion of such a theory is the problem? Is it possible to look beyond the shifting visions of landscape ecology and mathematical models to understand the inner workings of the biosphere itself?

In their paper ‘We Need to Talk (More Wisely) About Wisdom: A Set of Conversations About Wisdom, Science, and Futures’ (2019), Rafael Ramirez, director of the Oxford Scenarios Programme, and his three co-authors, argue that wisdom ‘includes practices which embrace uncertainty, ignorance and complexity’, is demonstrated in action, and is ‘only meaningfully assessable from the future’. They suggest that a way forward would include ‘post-normal science, scenario planning, and courageous conversations’.

At first glance, these three suggestions appear to be a sort of yogic meditation for scientists. While none of them explicitly offer a language for achieving wisdom, ‘post-normal science’ proposes something new – that to properly understand the complex and uncertain world in which we dwell, and to make wise decisions, we will need to acknowledge and accommodate multiple legitimate perspectives. For pandemics, the concept implies that wisdom will come only when we expand our peer community to include other species.

One might begin with macroscopically visible and economically important organisms such as arthropods. While Cartesian science has enabled us to classify arthropods, we’ve rarely examined the chemical grammar of their languages beyond what we need to spy on their world, and to kill them. Only occasionally do we grapple with how dung beetles orient in a landscape using the stars, or migrating butterflies respond to magnetism. If, as the Baltic-German biologist Jakob von Uexküll proposed in the mid-20th century in his pioneering work on the Umwelt of nonhuman animals, we could begin to understand how other animals sense their interactions with us and our shared world, we might open possibilities that go beyond theories and models constructed from a science of things to pandemic wisdom itself.

‘Viruses are one of the most dominant drivers of evolutionary change’

Pandemics appear to us in the form of rogue bacteria or viruses, but what do we know of the invisible world around us from which they arrive? Rather than focusing only on identifying and classifying fungi, bacteria, plants, animals, nucleotides, amino acids and viruses, we might query the important roles that these things have played as active characters in the larger narratives of evolution and life. In their provocative book Microcosmos (1986), Lynn Margulis and Dorion Sagan reframed the evolution of multicellular organisms such as humans as bacterial symbiosis – bacteria literally combined, they hypothesised, to form the cells comprising us today.

Researchers since then have uncovered evidence that pathogens exert ‘the strongest selective pressure to drive the evolution of modern humans’. Among the drivers, look to evidence that prehistoric pandemics played a role in selecting for ancestral traits and behaviours that we recognise as human today. Scientists following another thread in this evolutionary narrative describe viral nucleic acids insinuating themselves into our genetic codes. The biologist David Enard at Stanford University in California and colleagues have concluded that ‘viruses are one of the most dominant drivers of evolutionary change across mammalian and human proteomes’.

Microbial populations work together to accomplish the feat. Indeed, the biologists Bonnie Bassler and Steven Rutherford at Princeton University in New Jersey describe quorum sensing, in which bacterial populations coordinate group behaviour. Bassler’s research with Kai Papenforth reveals how bacteria share information and converse with each other and with the world they inhabit – including ourselves.

Building on this, other scholars have argued that the ‘microbial microcosm is a compelling narrative that situates our human biome in the biome of the planet, and in doing so, provides a common language to bridge efforts across and between movements, humans, and our natural environments.’ This globalises Pavlovsky’s concept of natural nidality and, in so doing, changes our understanding of ourselves as biological beings in this world.

Grounded in European traditions of natural science and medicine, the American etymologist Lewis Thomas in 1987 reflected that:

for all our elegance and eloquence as a species, for all our massive frontal lobes, for all our music, we have not progressed all that far from our microbial forebears. They are still with us, part of us. Or, put it another way, we are part of them.

Complementing and extending this, the health scientist and Torres Strait islander Kerry Arabena has drawn on her Indigenous heritage to ponder what it might mean to see ourselves as being ‘Indigenous to the Universe’. She defines this as ‘a living practice, a way of life’ that acknowledges reciprocal relationships among all species and the landscapes in which we dwell.

As we become more deft at exploring the nested, dynamically complex relationships among viruses, bacteria, fungi and ourselves, we’ll come closer to grasping how pandemics emerge from a rupturing and rearranging of these relationships. From this deep linking of Aion with Chronos, we can already see the outlines of the wisdom that pandemics offer us. What we’re beginning to faintly understand is this: if we wish to survive as a species, we must gather all of our knowledge from multiple perspectives – however fragmented and partial – and actively engage in conversations with the world we inhabit and that gives us life. Only then will we begin to understand ourselves, and live up to our name, the wise ones, Homo sapiens sapiens.

David Waltner-Toews

is a Canadian veterinary epidemiologist. His books include Food, Sex and Salmonella (2008), The Origin of Feces (2013), Eat the Beetles! (2017) and On Pandemics (2020). He lives in Ontario.
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