For viruses, uglier might be better

On the issue of what should have been done to tame the COVID-19 pandemic — crucial steps that were missed — commentators have no shortage of blunders to highlight. We didn’t start testing fast enough, and we still haven’t achieved the testing capacity we need to test widely. People who were ill and told to self-isolate didn’t stay home. Patients were released from hospital and quarantine before their cases had resolved. Health-care workers faced (and still face) shortages of personal protective equipment.

On the issue of what went wrong that mere mortals couldn’t control, however, the COVID-19 pandemic presents an even longer list.

SARS-CoV-2, the virus that causes COVID-19, has turned out to be an exceptionally hearty pathogen with just the right characteristics to effectively infect a great number of human beings. Everything from the exact shape of its little spikes, which make it stick so well to our cells, to its unusual ability to infect both our upper and lower airways, apparently allowing it pass easily from person to person as well as to create severe symptoms, when most viruses have only one of those vices, make it uniquely damaging.

What SARS-CoV-2 seems to have won in the human virus lottery is the prize of good balance. The disease it causes in us, COVID-19, can be deadly, but it can also be just mildly inconvenient and even plain unnoticeable, which makes it harder to avoid. Strange as it may sound, as Discover Magazine blogger Neuroskeptic has hypothesized, part of the problem for humans may be that COVID-19 is simply not disgusting enough to activate what he terms our behavioural immune system.

Not only does that seem intuitively right, but Neuroskeptic reminds us that research on disease avoidance has shown “we are primed to be disgusted both by skin abnormalities (spots and rashes especially), and by bodily fluids — both of which can spread contagion.” And COVID-19 causes little of either.

Other infectious diseases have revolting symptoms. Ebola sufferers spout black vomit and bleed from more orifices than any of us would like to think about. People who fall victim to bubonic plague have painful and painful-to-look-at swellings in their necks, thighs, and groins — swellings that sometimes turn black and rot the flesh around them and other times emit large amounts of pus. (These swellings are known as buboes, hence the plague’s name.)

It is rarely necessary to convince people to stay at least six feet away from symptomatic people with Ebola or bubonic plague.

Just the mental images of one or two people in the community who are sick in this way are enough to create organic social distancing.

Ironically, because people sick with COVID-19 have symptoms that are less gross, humans are probably less preprogrammed to avoid them and to avoid becoming like them. Even the frightening and truly awful prospect of being on a ventilator doesn’t create quite the same instinctual revulsion as does the disfigurement caused by leprosy or smallpox. (And wouldn’t you know it, leprosy isn’t even highly contagious.)

But that’s not the only way that SARS-CoV-2 has been lucky.

If it caused a disease that killed more of the people it infected, it might have burned itself by out now. Premature deaths are traumatic, and we want to do everything in our power to prevent them (even if some of the recent economic musings have suggested otherwise), but from a clinical point of view, deaths are convenient for fighting viruses because dead people don’t go around town spreading infection. Remember SARS and MERS? You probably do but only foggily. They are other potentially fatal coronavirus-induced diseases that have caused human outbreaks, but because they are about eight to 10 times deadlier

MISTAKES IN OUR HANDLING OF COVID-19, AND WE SHOULD LEARN FROM THOSE ERRORS.

than COVID-19 (numbers won’t be truly accurate until the current pandemic is over), they killed too many of their hosts (otherwise known as us) before they could get very far.

Even SARS-CoV-2’s timing has been fortuitous for its spread. If it had emerged, say, 15 years ago, the United States would still have had its biohazard-fighting capabilities ramped up in response to the post-9/11 anthrax scares. By the time SARS-CoV-2 popped up, the memories of anthrax terror had faded and many of those resources had been cut.

We’ve made plenty of mistakes in our handling of COVID-19, and we should learn from those errors. Human reasoning is a powerful force. As big a this problem is, and as great the challenge it poses, people have solved bigger and overcome greater. It would be shameful if we didn’t make the utmost effort to conquer it.

But it’s worth remembering that ultimately, the list of things beyond our control that have made this virus so uniquely destructive is even longer than the list of things we’ve done wrong. Faced with the might of evolutionary biology, we humans still do seem awfully small.