Support The Bulwark and subscribe today.
  Join Now

We Can Be Better Than COVID-19

Dial back the triumphalism and the judgmentalism. We're all in this together.
March 16, 2020
We Can Be Better Than COVID-19
(Photo by Stephen Chernin/Getty Images)

Everyone is looking for silver-linings in the COVID-19 pandemic, which is only natural. In the tech sector, for example, many people have decided that one of the up-sides of the crisis is that it has demonstrated the fantastic power of artificial intelligence.

The argument is that AI helped doctors anticipate, diagnose, and formulate treatments for COVID-19.

The truth is somewhat less fantastic.

In MIT’s Technology Review, Will Douglas debunked these claims, concluding that “AI could help with the next pandemic—but not with this one.” Where AI has made an impact, it’s been in ways that we might not like. The Wall Street Journal’s Tech News podcast points out that the most consequential implementation of AI during this crisis may have been China’s use of facial recognition to identify and report citizens who were using public transportation without wearing masks.

In other words, so far AI has been most useful as a means to extending an authoritarian regime’s surveillance capabilities, and in this one instance that may have contributed some unmeasurable public health benefit. Yay?

And advances in the biotech sector have not been terribly impressive, either.

We are more than 60 years into the molecular age (Watson and Crick first published their double helix structure of DNA in 1953) and the two most valuable remediation techniques at our disposal are the admonitions to (1) wash your hands and (2) isolate the afflicted. According to the CDC, this latter technique was developed in the Middle Ages.

This isn’t to say that we’ve learned nothing in the ensuing 700 years: the supportive care afforded to those who are critically ill is an extraordinary achievement, the result of iterative—and often unheralded—improvements in processes over time. And it seems that real and rapid progress is being made toward the development of potential therapies (to treat the disease), and vaccines (to protect from it)—but the proof here will be in the eventual clinical trials.

To their credit, physicians and other health care providers tend to be painfully aware of the limitations of their armamentarium, and feel a powerful sense of humility in response to this pandemic.

Yet the worst attitude elicited by the current crisis isn’t hubris, but disdain. There is a sense emanating from certain sectors that there would be karmic justice if MAGA zealots who believe more strongly in the Deep State than in science were to become preferentially infected with coronavirus because they dismissed precautions around social distancing and regarded these public health admonitions as an anti-Trump conspiracy.

You may have heard of the Darwin Award, the satirical prize given to people who are killed by their own foolishness. Example: A lawyer who dies after running through a skyscraper window, trying to demonstrate its safety. Or a rhino poacher stomped to death by an elephant (then digested by a lion).

There is, here and there in the tech and science communities, the whispered belief that Trump supporters who disdain public health advice like social distancing are lining up to win their own Darwin Awards and that if they start dropping like flies, they will have gotten what they deserved.

This notion is deplorable and runs directly counter to the spirit of medicine. And it must be stamped out. Immediately.

One of the best things about being a doctor is the bedrock commitment to helping each person in need. When you approach a patient as a physician, you don’t take on the complex moral calculus of how complicit someone may or may not be in their condition, and then titrate care and concern accordingly. You attend to each person equally, and without qualification.

Beyond that, to be a physician is to recognize that diseases afflict all of us; while those with the least are often the most susceptible to illness, all of us can, at a moment’s notice, move from the realm of the well to the realm of the sick. As Susan Sontag eloquently wrote,

Illness is the night-side of life, a more onerous citizenship. Everyone who is born holds dual citizenship, in the kingdom of the well and in the kingdom of the sick. Although we all prefer to use only the good passport, sooner or later each of us is obliged, at least for a spell, to identify ourselves as citizens of that other place.

As long as disease has existed, there’s been a tendency to attribute illness to a failing of the sufferer; yet while someone’s behavior and choices often plays a role in illness—smoking predisposes to lung cancer, and obesity contributes to the prevalence of type 2 diabetes—doctors know that although prevention is important, illness can strike anyone. Which is why physicians aspire to offer you understanding, rather than judgment.

When I started my medical training, one of the things which struck me is just how much so many people are dealing with, all the time. We get a sense of this from the occasional celebrity revelations: rapper Lil Wayne coping with epilepsy; Giants great Tiki Barber managing his sickle cell disease; Supreme Court Justice Sonia Sotomayor living with type 1 diabetes since she was a child; the revelation that President John F. Kennedy suffered from an adrenal gland deficiency called Addison’s Disease; and former Colorado Governor John Hickenlooper, former Illinois Senator Carol Moseley Braun, and Colorado’s senior Senator Michael Bennet, who each have overcome dyslexia.

The arrival of a global pandemic upon our shores, despite the insistent skepticism of the president and his supporters, should not be looked at as a victory of science over the heathens.

Instead, this pandemic should remind us just how far science and technology still have to go, while reawakening our sense of responsibility to care for all the afflicted, to the best of our ability, and with all our hearts.

The most appropriate response to misplaced arrogance and self-regard isn’t the transposition of these qualities from politicians to scientists.

It’s to replace these reflexes with the humility that science demands, and the empathy our patients—all of them—deserve.

David Shaywitz

David Shaywitz is a physician-scientist at a biopharmaceutical company, an adjunct scholar at the American Enterprise Institute, and a lecturer in the Department of Biomedical Informatics at Harvard Medical School.