The post that follows is longer than usual, because I wrote it as a column for the “Being Lutheran” series of Valparaiso University’s journal, The Cresset. Unfortunately (and ironically, given the article’s subject), the pandemic has compelled the University to make many fiscal cutbacks, among them the suspension of The Cresset‘s publication for at least the next two years. The journal’s editor, Heather Grennan Gary, has kindly given me permission to post the article to my blog site. Please note that the article was written over three months ago; I have not sought to update it.
There is a certain risk in writing on a topic that is dominant in the news now (late March 2020) for a publication that will not appear for at least a few months yet. Still, I shall give it a go. If what follows is by the time of its appearance (and by the grace of God) a “period piece,” so be it. I shall argue in what follows that there are still lessons to be learned and points to be taken. On the other hand, every present indication is that we are apt to be dealing with this pandemic for some considerable while. If so, I offer the following in the hopes that it may be analogous to what Baltimore Colts great Johnny Unitas said of his passes: not thrown directly to readers, but to readers where they will be when the ball gets there.
My title is, of course, adapted from the celebrated 1985 novel by Gabriel García Márquez, Love in the Time of Cholera. But the impetus for my reflections comes from a non-fiction work that I just finished reading: Frank M. Snowden’s Epidemics and Society: From the Black Death to the Present. To be sure, Snowden’s “present” is 2018, so he concludes with reflections on SARS and Ebola, not COVID-19. But as I processed his account through the lens of my present, I came to see that there is much that we have failed to learn from our past. So, in George Santayana’s oft-quoted epigram, we are condemned to repeat it.
Of all the doleful chapters in Snowden’s book, the one that most caught my inner eye was his account of the successful, American-led effort to eliminate malaria on the Italian island of Sardinia in the immediate aftermath of the Second World War. In a nutshell, the campaign (and it was conceived and executed in terms of a military operation) focused on a single vector of attack: the application of copious amounts of the pesticide dichlorodiphenyltrichloroethane (a.k.a. DDT). The objective was to eliminate the Anopheles labranchiae mosquito whose bites transmit the parasites Plasmodium falciparum and Plasmodium vivax that, in turn, engender malaria in humans. In ways considered comparable at the time to the Allies’ complete victory over the Axis in 1945, the war succeeded by the early 1950s.
However, as Snowden goes on to explain, there were numerous aspects in which this “victory” must be termed narrow at best and more aptly Pyrrhic.
First, the world community (led by epidemiologists at the time) learned many wrong lessons from Sardinia, beginning with the assumption that what had been done there was scalable to the point that, given enough DDT, the world could be rid of malaria, just as it was on the way to eliminating smallpox. Not so. To put the matter bluntly, Africa (where malaria to this day is most virulent) is a considerably larger island than Sardinia. It is also much more diverse as one confronts the “facts on the ground.” Scalability was only the tip of the iceberg faced by those with the hubris to imagine that Sardinia could be replicated on a continent-wide canvas—to say nothing of a worldwide one.
Along these lines, those who wrote the reports on the Sardinian campaign conflated the most obvious and important factor in the elimination of malaria (i.e., DDT) with its being the sole factor. At least two other changes corollary to the campaign played notable roles. First, the DDT had to be applied, so numerous Sardinians were hired and paid a good wage (by local standards), so that poverty and its concurrent dangers to health were reduced. Secondly, the limitation of the range of the mosquitoes and their malaria enabled more land to be cultivated. Increased food supplies (and farmers’ income therefrom) also made a difference.
Thirdly, often lost in the telling of the story was an official, Italian effort that had been underway since 1900 to eradicate malaria on Sardinia through the administration of quinine and the establishment of rural medical centers and schools to serve and teach Sardinians about the nature of malaria and how the new drug fit into its suppression. The American postwar campaign did not land on an insula rasa. Snowden notes that this earlier, more holistic effort had mixed success for a long time, but at very least it prepared Sardinian hearts and minds to support the DDT-based campaign.
As a final note by way of summary, Snowden has the integrity as an historian not even to mention what was later learned of DDT, viz., that it both wrecks the ecosystem to which it is applied and is carcinogenic in humans. Fashionable as it is these days in some circles, retroactive criticism via 20/20 hindsight can be mean and unfair. In this case, most famously, Rachel Carson’s Silent Spring did not appear until 1962. Still in all, so much the worse for the American-led Sardinian campaign against malaria.
So, to quote the rabbinic sages, “What does this teach us?” I am no scholar of public health, nor a medical researcher, so my evaluation of the technical, medical steps underway now and in the coming months must yield to those with scientific expertise. However, a humanist (yea, even a theologian) may still dare to contribute to the conversation, as I shall attempt in the points that follow.
First, we are all caught between two realities: quarantines and cordons sanitaires do help slow down the spread of disease, but they cannot stop it, regardless of how draconian a regimen is enacted. Otherwise put, national and state borders are one place to attempt to draw proverbial lines in the sand, but like the waters of the presently overfull Lake Michigan that have devastated the little beach at our home, germs have little regard for political or even natural boundaries, and once they have transgressed those borders (as they will), the most that exclusion regimens can hope for is to buy time (or, in the phrase du jour, to “flatten the curve”). The upshot is that we truly are all in this together. As Snowden put it toward the end of his chapter on Sardinia: “Malaria, like all epidemic diseases, is a crisis not of nations, but of humanity.” (Snowden, 384)
Secondly and as a corollary, while I would not go so far as to claim that an epidemic is a cultural construct (nor do I read Snowden that way), times like this do offer humanity a chance to reflect on our place in the world. Genesis 1 tells us that humanity is unique in being created in the image of God and in being delegated the responsibility of stewardship of creation. Situations like the present one remind us that we may be stewards, but we are not gods, and that, mindful of the many ways in which we humans have betrayed our trust in God’s ecology (and economy, in the classic sense of “plan”), we are very much both in creation and of creation. In fact, a favorite quotation of mine from the otherwise utterly gnostic tale of the 1999 movie The Matrix reminds us that, from a certain perspective, we have more in common with the enemy whom we now confront than we would readily concede. The following words come from “Agent Smith,” a representative of the powers that would shield humanity from reality, to “Morpheus,” a leader of those who would bring the truth to light:
“I’d like to share a revelation that I’ve had during my time here. It came to me when I tried to classify your species and I realized that you’re not actually mammals. Every mammal on this planet instinctively develops a natural equilibrium with the surrounding environment but you humans do not. You move to an area and you multiply and multiply until every natural resource is consumed and the only way you can survive is to spread to another area. There is another organism on this planet that follows the same pattern. Do you know what it is? A virus. Human beings are a disease, a cancer of this planet. You’re a plague, and we are the cure.” (The Matrix IMDb)
Reframing the present pandemic as virus versus virus ought at least to provoke our reflection on the larger picture of our place in the world, beyond present directives to “shelter in place.” Which will win out, numbers or wits? And what does it say of our self-absorption that the entire coronavirus affair, which threatens (so far as I know) only one species on Earth (i.e., the ones with the “wits”), has all but driven from our consciousness the larger threat that we have wrought to the continuation of life as we know it on this planet? The approaching “tipping point” was only, finally coming to our full, global awareness when we all got distracted.
Thirdly, if we learn nothing else from our adventure in Sardinia seventy years ago, it should be that there can never be a “magic bullet” to solve pandemics like the present one. Even if an inoculation were issued tomorrow in sufficient quantity both to cure those with the coronavirus disease and to prevent anyone else from getting infected (a contrary-to-fact conditional if ever there was—or is it “were”—one), we would simply be “kicking the can down the road” until the next go-round with another microbe. So long as those Dickensian waifs who stood concealed beneath the robe of the Ghost of Christmas Present, i.e., ignorance and want, are still alive and in our midst in quantity, humanity will not be safe (Dickens, 94-95). As of this writing, the depredations of COVID-19 have largely been felt in the northern hemisphere (where, to be sure, ignorance and want are plentiful), but the ghastly consequences of its dispersal among the peoples of the “Two-Thirds World” of the South (which is just now getting underway) beggar the imagination. Just think malaria. Or Ebola. Or HIV/AIDS.
Science fiction (which I often assigned to my students, explaining that it was really about this world) is full of stories of humanity finally (and too often temporarily) united only when an attack from outside the Earth confronts us. (I think of a work beloved by one of my children years ago, Orson Scott Card’s Ender’s Game.) Can we, even at this late date, find the will to rise above finding rolls of toilet paper for our own private stashes to make a dent in issues that really matter for the world and its people? Snowden’s concluding paragraph pulls together much from his historical recounting. He is writing of the international effort to counter Ebola in West Africa from 2014-16, but he could as well have placed the same paragraph at the end of nearly any of his chapters (or, I would argue, the chapter that we are now all writing):
“Epidemic diseases are not random events. As we have seen throughout this book, they spread along fault lines marked by environmental degradation, overpopulation, and poverty. If we wish to avoid catastrophic epidemics, it will therefore be imperative to make economic decisions that give due consideration to the public health vulnerabilities that result and to hold the people who make those decisions accountable for the foreseeable health consequences that follow. In the ancient but pertinent wisdom, salus populi suprema lex esto—public health must be the highest law—and it must override the laws of the marketplace.” (Snowden, 505)
I am neither a pessimist nor an alarmist by nature. But we could do a whole lot worse in the present circumstance than take up Martin Luther on his plan for the day before the end of the world: go plant a tree.
Card, Orson Scott. Ender’s Game. NY: Tor, 1985.
Carson, Rachel. Silent Spring. Boston: Houghton Mifflin, 1962.
Dickens, Charles. A Christmas Carol. Orig,. London: Chapman & Hall, 1843. Citation from NY: Garden City, 1938.
Márquez, Gabriel García. Love in the Time of Cholera. Orig., El amor en los tiempos del cólera: Columbia: Oveja Negra, 1985; Eng trans.: NY: Knopf, 1988.
The Matrix IMDb: https://www.imdb.com/title/tt0133093/quotes/?tab=qt&ref_=tt_trv_qu (consulted 3/24/2020).
Snowden, Frank M. Epidemics and Society: From the Black Death to the Present. New Haven: Yale, 2019.