Monday, March 30, 2020

The Deadliest Virus: The Science and Politics of the Flu Pandemic of 1918

HASKELL COUNTY

In Haskell County, Kansas, in late January of 1918, Dr. Loring Miner began to see a new form of influenza in his patients that frightened him because it was so deadly; and as someone who read the Greek classics, he might have worried about whether this could come to resemble the plague in Athens described by Thucydides.  Although it cannot be proven, historian John Barry--in his book The Great Influenza--presents the circumstantial evidence for inferring that this was the origin of the flu pandemic of 1918-1920 that would spread over the whole Earth and kill over 50 million people, making it the deadliest pandemic in history.  Although the coronavirus that has caused the COVID-19 pandemic differs from the H1N1 flu virus that caused the 1918 pandemic, studying that earlier viral pandemic helps us understand what we're facing now.

Dr. Minor was so disturbed by the disease he saw spreading around Haskell County that he notified the U.S. Public Health Service, which published this one-sentence notice in its Public Health Reports journal (April 5, 1918): "On March 30, 1918, the occurrence of 18 cases of influenza of severe type, from which 3 deaths resulted, was reported at Haskell, Kans."  Actually, March 30th was not the correct date.  Minor first saw these "cases of influenza of severe type" in January and February.

Dr. Minor took pride in being a man of science.  He set up a laboratory for use in his medical practice.  He followed the recent developments in modern medical science such as the germ theory of disease.  And so he was prepared to recognize that he was seeing a new infectious disease in which a microbe--a bacterium or virus--was being transmitted by human contact.

Today scientists believe the H1N1 virus originates in marine waterfowl and jumps over to pigs before infecting human beings.  Haskell County was a farming area with lots of pigs from which the human infection might have started.  Since Haskell County was a sparsely populated and isolated area of southwest Kansas, the virus that first appeared there might have died out and failed to spread around the world were it not for the circumstances of wartime.

In February, young men from Haskell County were being drafted into military service for The Great War and sent to Camp Funston, three hundred miles away on the Fort Riley military reservation.  On March 4, a private at Funston reported ill with influenza.  Within three weeks, more than eleven hundred soldiers were admitted to the hospital with flu.  Pneumonia developed in 237 of these men, and 38 died.  When influenza kills, it kills through pneumonia.  This death rate was unusually high but not high enough to draw attention.  Soldiers from Funston were being shipped out to other military camps around the U.S., where they infected others; and these infected soldiers were then shipped to Europe, from where the epidemic spread around the world.

In the wartime camps, the men were crowded together in ways that permitted the quick transmission of the virus.  This is similar to the situation in Athens in 430 BC: in the circumstances of the war with Sparta, the people of Attica were crowded inside the walls of the city of Athens, so that once the infectious agent arrived (probably a virulent bacterium coming into the port of Piraeus), it spread quickly from person to person.

The first lesson here is that if these severely virulent infectious agents had been identified early enough--in Athens and in Haskell County, or in Camp Funston--and if the first people infected had been completely isolated from other people, then there would have been no epidemics.


DEATH RATES

In the spring of 1918, the flu epidemic spread around the world; but while some of those infected died, the disease was generally mild.  Still, the debilitating effects of the disease were severe enough that German commander Erich von Ludendorff blamed influenza for weakening so many of his soldiers that his last great offensive against the Allied powers stalled, which was the last chance for Germany to win the war before the fresh American troops arrived in Europe.

In the fall of 1918, a more deadly form of the virus caused a second wave of the pandemic with a horrifying death rate around the world.  By the end of the pandemic in 1920, 0.65% of the population of the United States had been killed--about 675,000 people.  In the developed world, Italy had the highest death rate--1% of its population.  In the less developed world, Mexico had a death rate of between 2.3% and 4%.

If the COVID-19 pandemic proves to be as lethal as the 1918 flu pandemic in the U.S., that would mean deaths at 0.65% of the present U.S. population of 330 million, which would be about 2,145,000 deaths.  This should be considered in the context of the normal yearly death rate: about 2,800,000 deaths from all causes, which include deaths from heart disease (650,000), cancer (600,000), accidents (170,000), influenza and pneumonia (56,000), and suicide (47,000).

The other day, Anthony Fauci predicted that the number of deaths from the coronavirus in the U.S. could eventually be as low as 100,000 or as high as 200,000.  If this turns out to be correct, then the COVID-19 pandemic will be much less deadly than the 1918 pandemic--killing 0.03% to 0.06% of the total population as opposed to 0.65%.

Fauci is assuming that the COVID-19 pandemic is inherently just as deadly as the 1918 flu epidemic, so that if nothing at all were done to suppress this epidemic, it would kill over 2 million people in the U.S.  He is also assuming that reducing the deaths to 100,000 to 200,000 requires all of the stringent measures for suppressing the epidemic that he has recommended--including self-quarantining, social distancing, and the partial shutdown of the U.S. economy for three months or more.  These policies for controlling this pandemic were developed some years ago by public health professionals who had studied the history of the 1918 pandemic to see what worked and what failed to contain the disease (Jester, Uyeki, and Jernigan 2018; Jester et al. 2018).


PHILADELPHIA

One of the most instructive cases from the fall of 1918 is Philadelphia.  On September 7, 300 sailors arrived from Boston at the Philadelphia Navy Yard.  On September 11, 19 sailors reported ill with symptoms of influenza.  Public health officials were aware of the deadly epidemic that had broken out in Boston's military bases, and so they feared that the same could happen in Philadelphia.  On September 18, some officials met with Dr. Wilmer Krusen, Director of the Philadelphia Department of Public Health, and they advised him that stringent measures would be needed to avoid the spread of the flu throughout the city--banning public meetings, closing businesses and schools, and quarantining the Navy Yard and civilians who had been infected.  The largest parade in Philadelphia's history was scheduled for September 28, a Liberty Loan parade designed to sell war bonds.  Krusen was warned that he should cancel this parade because the flu would spread quickly through the hundreds of thousands of people crowding the parade route.

Krusen rejected their advice, and he decided to do almost nothing to prepare for a possible epidemic emergency.  He did not want to cancel the parade or publicly acknowledge the epidemic because he thought that would weaken the morale of the public for supporting the war effort.  Indeed, wartime censorship prohibited newspapers from reporting about the epidemic.  The flu was called the "Spanish flu" because Spain was neutral in the war, and there was no censorship in Spain, so the Spanish newspapers reported the spread of the flu in Spain.  People then incorrectly assumed that the flu had originated in Spain.

On October 1, three days after the parade, every bed in all of Philadelphia's 31 hospitals was filled.  Hospitals refused to accept patients, who tried to bribe the nurses to care for them.  On that one day, 117 people died.

On October 3, five days after the parade, Krusen banned all public meetings in the city and closed all schools, churches, theaters, restaurants, and saloons.

On October 5, 254 people died.  The next day, 289 people died.  In some of the hospitals, over one-fourth of all the patients died each day, and their beds would immediately be filled by new patients.

The bodies began piling up.  Undertakers ran out of caskets, and they had no place to put the corpses.  People wrapped up corpses in sheets and pushed them into corners of their homes.  Some people were too sick to even move the corpses off their beds.

The symptoms of the disease were horrifying--with blood pouring from eyes, noses, ears, and mouths.  The lungs filled up until breathing was impossible, and with no oxygen in the arteries, people's bodies turned a dark blue color.

Normally, the death rate for flu is higher for the very young and the very old.  But this flu also killed young adults in the prime of their lives--from age 20 to 40.  This seemed odd because normally young adults have the strongest immune systems that allow them to fight off the flu.  In this case, however, the flu virus provoked the immune system into a massive attack on the body, and the lungs filled with debris and fluid.

Despite the high death rate, most of those infected survived.  (President Trump showed his ignorance when he said that in the 1918 epidemic most of those who contracted the disease died.)  There was no cure for the disease, but those who had caregivers so that they could rest while being fed and hydrated were most likely to recuperate, and then they would have immunity to the disease.  Nursing saved many lives.

As was the case with the plague in Athens, this flu epidemic brought out the best and the worst in human nature.  Many doctors, nurses, and others cared for the sick even though they were risking their lives.  But many others refused to care for others--even friends and family members--because they were afraid of having any contact with the sick.

In one week in the middle of October, 4,597 people died in Philadelphia.  After that, the number of deaths began declining.  The epidemic had reached its peak.

In Philadelphia, as in the rest of the country, the public policies for handling the epidemic came almost entirely from city and state governments.  There was no national policy coming from the federal government.  President Woodrow Wilson did not even speak publicly about the epidemic.

In some towns, public officials issued orders for partially closing down public life and quarantining people in their homes, but often these orders were not extreme enough to be effective.  In a few cases, however, a few small towns and communities were able to isolate themselves totally, and they escaped with no or very few deaths.


GUNNISON COUNTY

One example is Gunnison County, Colorado, which was the subject of a 2006 study by the Center for the History of Medicine at the University of Michigan Medical School.

Gunnison was a small mountain town in southwest Colorado, far away from any major population center but on a major rail line.  The city of Gunnison had a population of 1,329.  The County had a population of 5,590.

On October 8, 1918, the day after the Governor of Colorado and the State Board of Health had issued a warning about the flu epidemic reaching Colorado, the schools in Gunnison County were closed, and county officials introduced mandatory social distancing measures.  Gunnison police officers blocked all roads into the county, and anyone stepping off a train at the station would be arrested and quarantined for five days.  In effect, they isolated themselves from the entire world.  In early November, however, Mrs. Ellen Gavette, a 25-year-old, met her infected sister at the train station, who was returning from a trip.  They both self-quarantined themselves, but a few days later, Mrs. Gavette died from the flu.

On January 20, 1919, the schools were reopened, but attendance was not mandatory.  On February 5, the order of protective sequestration was lifted after almost four months of shutdown.

In mid-March of 1919, however, Gunnison was hit by the third wave of the flu epidemic, with over 100 cases of flu.  This time, there was no attempt to shut down the county.  At least 5 young people died from pneumonia.  But this death toll was remarkably low compared with the 8,000 deaths across Colorado.

This shows what a small community can do to almost completely isolate itself to escape contamination.  But this hardly seems practicable for larger communities over long periods.


MODERN SCIENCE AND THE MEDICAL MASTERY OF NATURE

The flu pandemic of 1918 was the first time that a fully modern science of medicine and public health confronted an aggressive global attack on humanity from nature.  For at least 2,500 years, until the end of the 19th century, medical practice was largely ineffective in preventing or curing sickness, because it lacked the scientific knowledge of the natural causes of disease and the scientific power to protect human beings from disease.  Doctors in the Hippocratic tradition of medicine, beginning in ancient Greece, could carefully observe the symptoms of disease to infer causes, but they did not probe deeply into nature with experimental methods or instruments to uncover the deepest causes.  So like the Hippocratic physicians, Thucydides could provide meticulous observations of the symptoms of the plague in Athens, which might help in the search for its natural causes; but he could not see its microbial causes, nor did he employ controlled experiments to see what preventative or curative treatments might work.

A few years ago, researchers collected DNA from teeth in an ancient burial pit in Athens dated to around 430 BC.  Testing the pulp for bacteria, they found a match to Salmonella enterica serovar Typhi, which is the bacteria responsible for typhoid fever, and this disease has many of the symptoms of the plague as reported by Thucydides.  Since the Athenians were crowded into Athens with unsanitary living conditions, it is easy to imagine how typhoid fever could have spread (Papagrigorakis et al. 2006).

By the end of the 19th century, scientists had identified typhoid fever as an infectious disease caused by a specific type of bacterium that is spread by food or water contaminated with feces.  Later, they developed an effective typhoid vaccine that was used successfully by the British army in the Boer War and in World War I.  Advances in public sanitation and hygiene--such as disinfecting drinking water--have also brought steep reductions in outbreaks of typhoid fever.  Later, in the 1940s, doctors began using antibiotics to reduce mortality from typhoid fever.  This is one of many diseases brought under control by modern medical science by the beginning of the 20th century--including smallpox, diphtheria, tuberculosis, cholera, malaria, yellow fever, and bubonic plague.

The germ theory of disease was the key idea for science confronting these infectious diseases--the idea that tiny living organisms invisible to the naked eye invade the body, multiply, and cause disease, with specific diseases caused by specific germs.

And yet, despite this success in the modern scientific battle with infectious diseases, scientists failed in their efforts to fully understand and control the flu epidemic of 1918.  They knew that isolating people worked in slowing or stopping the spread of the disease.  But beyond that, they were ignorant.  They could not even agree that the disease was influenza, because the symptoms looked so unlike normal influenza, that some scientists thought this was some new kind of disease.  They failed to find either a preventative vaccine or a curative serum for this disease.  Their only consolation was knowing that most people infected would recover if they were confined to bed rest and nursing care, and that those who recovered would have immunity.

The critically important part of their ignorance was that they could not identify the pathogen--the microbe that was the infectious agent of the disease.  Some thought it was a specific kind of bacteria--the "influenza bacillus."  Others thought it was some kind of virus.  Bacteria had been intensively studied, and they were visible through a microscope.  Viruses had been identified as microbes that were different from bacteria, but viruses could not be seen in their microscopes, and there was debate over exactly how they differed from bacteria.

Towards the end of the flu epidemic, scientists studying it began to agree that the primary cause was a virus, although the viral infection damaged the lungs in ways that made people vulnerable to secondary bacterial pneumonia infections.  Later, in 1926, Thomas Rivers defined the difference between viruses and bacteria--defining viruses as "obligate parasites," because they cannot reproduce themselves on their own, and so they must invade a host's cells and force those cells to reproduce more viruses.  The invention of the electron microscope in 1931 allowed viruses to be seen for the first time.


THE DISCOVERY AND RECONSTRUCTION OF THE H1N1 FLU VIRUS OF 1918

Over the past hundred years, since the end of the 1918 flu epidemic, scientists have wanted to understand why that flu virus of 1918 was so deadly and how it originated, with the thought that understanding this might help us to protect against any future epidemics that might be equally deadly.

Remarkably, over the past 25 years, scientists have succeeded in sequencing the entire genome of the 1918 virus, reconstructing the virus itself, and tracing its evolutionary history (Jordan 2019).  Scientists extracted the RNA of the 1918 virus from the lung tissue of victims of the epidemic, which had been preserved in a burial site in Alaska and in a U.S. Army collection of specimens.  Through genetic engineering, scientists eventually reconstructed the RNA of the complete 1918 virus.  This fully reconstructed 1918 virus could then be studied by being introduced into mice to see why this virus was so virulent.  This H1N1 virus has eight genes, and it was found that it was the unique combination of all eight genes working together that made it such an exceptionally virulent virus.

Beyond the inherent virulence of the virus itself, researchers identified at least five other factors that made the 1918 epidemic so dangerous.  First, the mobilization of troops in the war put so many people into overcrowded spaces that this infectious disease could spread quickly and widely.  Second, there were no diagnostic tests to identify flu infection; and the health experts did not even know that flu viruses existed.  Third, there were no flu vaccines, and no flu antiviral drugs.  Fourth, there were no facilities for intensive medical care or mechanical ventilation, so there was little that doctors could do to care for their patients.  Finally, there was no coordinated national planning to implement policies for mitigating the epidemic.

In the current crisis over the COVID-19 pandemic, we can see the efforts to overcome all five of these factors to escape a catastrophe like the 1918 flu pandemic.  It's a test of whether medical professionals, public health experts, and politicians have learned the lessons from that experience of 100 years ago.

Some of the horrific predictions about the likely death rate from the COVID-19 pandemic assume that the newly identified "severe acute respiratory syndrome-related coronavirus" (SARS-CoV-2) is just as inherently virulent as the H1N1 virus of 1918.  I am not sure there is convincing evidence for that.

Moreover, even as we battle this new virus, we should be encouraged that the H1N1 flu virus that has been circulating in the human population since 1918 has become must less dangerous than it was in 1918 (Carter and Sanford 2012).  There has been a continuous accumulation of mutations in this virus that have led to its degeneration, so that it is no longer as virulent as it once was.  A high mutation rate can sometimes bring rapid adaptation and evolution, but more likely just the opposite happens.  Deleterious mutations make viruses less adaptive and lead to their eventual extinction.  That seems to have happened to the flu virus of 1918.

The 1918 epidemic showed an extreme level of virulence unlike any other flu outbreak in history.  We can expect that with rapid mutation there will be a "reversion to the mean" as more extreme events are followed by less extreme events.  Once a virus has reached such an extreme of virulence, mutations are likely to make it less lethal rather than more lethal.

We can hope that this will be true for the SARS-CoV-2 virus.


REFERENCES

Barry, John M. 2018. The Great Influenza: The Story of the Deadliest Pandemic in History. New York: Penguin Books.

Carter, Robert W., and John C. Sanford. 2012. "A New Look at an Old Virus: Patterns of Mutation Accumulation in the Human H1N1 Influenza Virus Since 1918." Theoretical Biology and Medical Modelling 9:42.

Jester, Barbara, Timothy Uyeki, and Daniel Jernigan. 2018. "Epidemiology in History: Readiness for Responding to a Severe Pandemic 100 Years After 1918." American Journal of Epidemiology 187 (12): 2596-2602.

Jester, Barbara, et al. 2018. "100 Years of Medical Countermeasures and Pandemic Influenza Preparedness." American Journal of Public Health 108 (11): 1469-1472.

Jordan, Douglas. 2019. "The Deadliest Flu: The Complete Story of the Discovery and Reconstruction of the 1918 Pandemic Virus." Atlanta, GA: Centers for Disease Control and Prevention.

Pagagrigorakis, Manolis, et al. 2006. "DNA Examination of Ancient Dental Pulp Incriminates Typhoid Fever as a Probable Cause of the Plague of Athens." International Journal of Infectious Diseases 10: 206-214.

Friday, March 27, 2020

Deadly Epidemics as a Challenge to Darwinian Liberal Science: Athens (430-429 BC)


Pandemics pose a challenge to the Darwinian liberal science that I have defended on this blog.  I have argued that a Darwinian liberal science promotes the moral, political, and intellectual progress of humanity by securing the conditions for satisfying the natural human desires for life, liberty, and intellectual understanding.  But the deadliest pandemics--like the plague in Athens, the flu pandemic of 1918, and the COVID-19 pandemic today--seem to show the deadly power of nature to frustrate those desires.

They seem to show that our Darwinian science of nature fails to give us enough knowledge of and power over the natural world to protect ourselves from deadly infectious diseases.  Those pandemics also seem to show that our efforts to control them force us to sacrifice our individual liberty as we submit to the authoritarian regime of public health planning.  And insofar as those public health policies can never fully succeed, many human lives will be lost.

I admit that this does show how Darwinian liberal science is, and always will be, limited in how far it can go in fully satisfying those desires for life, liberty, and intellectual understanding.  Nevertheless, I still contend that the history of pandemics manifests the progress of the Liberal Enlightenment and Darwinian science in improving, even if never perfectly attaining, the conditions for gratifying those desires.

I have written about the plague in ancient Athens (here and here).

The plague appeared in Athens for the first time in the summer of 430 BC, the second year of the war between Athens and Sparta.  Pericles, the preeminent military and political leader of Athens, died from the disease in 429 BC.  Oddly, Pericles probably had some responsibility for the plague because of his policy of forced evacuation of the rural population of Attica from the countryside inside the walls of Athens during the invasion of the Spartans.  The confinement of so many people crammed into the city created the conditions for the spread of the disease, which probably entered at the port at the Piraeus.

Thucydides was infected, but he survived; and his immunity allowed him to study the disease in others.  In his history of the Peloponnesian War, he carefully describes the history of the disease and its effects.  Like Hippocrates, he was looking for the natural causes of disease rather than assuming that such a disease must come from the gods.  He noticed that those people who prayed to the gods apparently failed to alter the course of the disease.  People even stopped worshipping the gods.

Like other careful observers, he could see that the disease was somehow passed through the transmission of some natural agent from one person to another.  But his scientific observations were limited by the fact that the bacterial and viral causes of this disease were invisible to human beings without microscopes.

The plague killed as many as 80,000 people, which was about one fourth of the entire population of Athens.  Although this weakened Athens for a few years in the war with Sparta and her allies, Athens recovered quickly economically, militarily, and culturally.  In the fourth century BC, Athens reached its greatest efflorescence--as measured by wealth (per capita consumption), population growth, and cultural achievement (including the philosophical schools of Plato and Aristotle).  This happened because Athens was an open access society with democratic, economic, and intellectual liberty.  I have written about this here.  This shows how a free society renews itself even after suffering the most deadly epidemic.

In On the Nature of Things, Lucretius continued the work of Thucydides in looking for the natural causes of human history including disease, and he spoke about how the human progress in natural discoveries and inventions has given human beings increasing power over nature, which some readers have seen as anticipating Francis Bacon's modern project for progress through political enlightenment and technological science.

But some Straussian readers of Lucretius--particularly, John Colman--have rejected this Baconian interpretation of Lucretius by pointing out that he ends his book with a darkly disturbing description of the plague in Athens, which seems to "correct" his account of technological progress by indicating the limits to the human power over nature.  I disagree with this because I see Lucretius as suggesting that while human power over nature can never be absolute, it can be increased as our knowledge of natural causes increases.

In fact, Lucretius was the first philosopher to explain diseases such as plagues as caused by germs (or "seeds") that are invisible to ordinary human vision.  In modern times, the germ theory of disease and the microscopic study of microbes has increased our knowledge of bacterial and viral diseases in ways that has allowed us to lessen or even eliminate these diseases.

In my next post, I will compare the plague in Athens with the flu pandemic of 1918-1919, in which we can see for the first time modern science confronting a global outbreak of disease.


How Many Will Die in the Coronavirus Pandemic? Neil Ferguson's Surprising Turn

You may remember that the decision of the Trump Administration to impose a partial shutdown of the American economy to slow the spread of the COVID-19 virus was based largely on the pessimistic predictions of Neil Ferguson and his colleagues at Imperial College London.  Now, suddenly, Ferguson has changed his mind.

In his original report, Ferguson said that the COVID-19 virus showed "comparable lethality to H1N1 influenza in 1918."  That was scary, because the 1918 flu pandemic killed over 50 million people around the world, including 675,000 in the U.S. and 228,000 in Great Britain; and that's a stunning proportion of the world population at that time--about 1.9 billion as compared with 7.8 billion today.

Ferguson's epidemiological model predicted that if nothing drastic was done to slow the spread of the virus, there could be 510,000 deaths in Great Britain and 2.2 million in the U.S.  To avoid this terrifying death rate, he recommended a massive effort at epidemic suppression that would shut down much of the economy in the U.S. and Great Britain.  He has been an adviser to Boris Johnson, and a few days ago, the British government imposed a shutdown like that in the U.S.

But now, two days ago, Ferguson testified to the UK's parliamentary Select Committee on Science and Technology; and he said that deaths from the COVID-19 virus in the UK are unlikely to exceed 20,000, and they could be even lower than that.  20,000 is an amazing drop from 510,000!

In the 1918 flu pandemic, the 228,000 deaths in the UK were 0.53% of the population of 43 million.  If the same proportion were to die today, that would be 339,200 out of a population of 64 million.

By contrast, Ferguson's prediction of 20,000 deaths is 0.03% of the UK's population of 64 million.  The same proportion of the U.S. population of 330 million would be 99,000 deaths.

The possibility of 99,000 deaths is disturbing.  But keep in mind that the typical rate of deaths from the yearly flu epidemics in the U.S. is 12,000 to 61,000.

Ferguson has recommended that the shutdown should continue until a vaccine is developed, which would require 12 to 18 months.  But in his testimony, he admitted that this was "impractical," because this would be an unacceptable social and economic disaster.  "We'll be paying for this year for decades to come," he said.

In his original paper, Ferguson said that he was not considering the "ethical or economic implications" of the possible strategies for dealing with the pandemic.  But that's not true.  By recommending an economic shutdown, he was making the ethical and economic decision that the moral costs of such a shutdown were less than the benefits of saving some lives of people who would otherwise die.  Is that true?

The 1918 flu pandemic was much more terrifying than this COVID-19 pandemic, not only because the death rate was much higher, but also because over half of those deaths were young adults (20 to 40 years old), so that the loss of prospective lifetimes was much greater than is the case with COVID-19, which tends to kill only older people with health problems, who already have short life expectancies.

Some people say that the harm from an economic shutdown to slow the pandemic is justified because life takes priority over liberty.  But when people's livelihoods are destroyed, isn't that an assault on their life?  And can't we predict, as I have in a previous post, that as this shutdown continues, people will engage in civil disobedience by reopening closed businesses and resuming their normal lives--in defiance of governmental orders?  Don't they have a natural right to do that?

Most of what is required to slow this pandemic--such as social distancing, washing one's hands repeatedly, staying home when one is sick, and isolating those older people who are vulnerable--can be done without shutting down the economy.  Why isn't that the most prudent policy?

Saturday, March 21, 2020

Was the Coronavirus Created by the (Evil) Intelligent Designer?


Is the coronavirus intelligently designed?  If so, does that show the evil of its intelligent designer?  Or is it the unintended product of a natural world created by the beneficent intelligent designer, in which viruses generally have a good role to play?

Some people believe that the coronavirus was bioengineered in a U.S. military bioweapon laboratory. It was introduced into Wuhan to cripple China's economy, to advance "the New World Order globalist cabal to implement the Super-Vaccination Agenda," and to achieve the depopulation of the Earth.  Some scientists in India have reported that COVID-19 has HIV (AIDS) virus-like insertions that are not found in any other coronavirus.  If this did not come from random mutations, the conspiracy theorists claim, then it must be "by purposeful and malevolent design."

Another conspiracy theory promoted by Senator Tom Cotton and Fox News is that the coronavirus is a biological weapon designed in a Chinese military lab just outside of Wuhan that somehow found its way into the Wuhan food market.


The viral social media spread of these conspiracy theories about the coronavirus has become a mimetic epidemic.

If the coronavirus was created not by human intelligent designers but by a divine intelligent designer, then we would have to wonder whether such an intelligent designer is evil in designing microbes that kill human beings.  Or can we see the overall goodness of an intelligently designed natural world, which nevertheless allows for the unintended evil of some viruses that evolve in ways that make them deadly threats to human life?

Michael Behe is a microbiologist who has been one of the leading proponents of Intelligent Design Theory, who is known for his argument that some biological mechanisms (like the bacterial flagellum) show the "irreducible complexity" that is the signature of an intelligent designer rather than Darwinian evolution.  I have written about his arguments here and here.

In his book The Edge of Evolution, Behe claims that many of the biological causes of human disease and death--such as the HIV virus and the malarial parasite--show the signs of intelligent design.  This leads him to doubt the goodness of the intelligent designer.  He concludes that "an intelligent designer deliberately made malaria," and thus it seems that the intelligent designer deliberately decided to kill millions of human beings, including innocent children (237).  When we see how "horrific" life on earth really is, Behe suggests, we must wonder: "Maybe the designer isn't all that beneficent or omnipotent" (239).  After all, the intelligent designer is responsible for creating "nature red in tooth and claw" (43).  The intelligent designer might actually be an evil demon (238).  This is a disturbing possibility for someone like Behe, who is a devout Catholic.

Now, Behe has said (here) that the COVID-19 virus is clearly intelligently designed.  It must be well designed to succeed in invading human cells.

A protein on the surface of the virus must bind specifically to a receptor protein on the surface of the cell--like a key that fits into a lock and opens it.  Viral mutations can change the shape of the key at random, and sometimes this random variation stumbles upon a key that fits the lock.  Sometimes a viral key that binds to an animal protein (perhaps in a bat) mutates and becomes able to bind to a similar human protein.  The virus can then jump from the animal to a nearby human and become very virulent.  Apparently, this is what happened in the Wuhan food market.

Behe writes:
"So, do I think viruses were designed?  Yes, I most certainly do!  The viruses of which we are aware--including the coronaviruses, Ebola, and HIV--are exquisitely, purposively arranged, which is the clear signature of intelligent design.  Well, then does that mean the designer is evil and wants people to suffer?  No, not necessarily.  I'm a biochemist, not a philosopher.  Nonetheless, I see no reason why a designer even of such things as viruses should be classified as bad on that basis alone."
". . . if we were on a ship in a powerful storm, we might be excused for thinking storms are bad.  But in calmer moments we understand that on balance the ocean is very good and that, given an ocean and the laws of nature, storms will arise from time to time.  What's more, we just might get caught in one.  In the same way, most viruses do not affect humans and may well have a positive, necessary role to play in nature of which we are currently unaware.  (I would bet on it.)  From time to time a storm arises in the virosphere and affects humans.  But that's no reason to think either that viruses weren't designed or that the designer of viruses isn't good."
In saying the viruses may have a good role to play in nature, Behe cites the research of Marilyn Roossinck (2011, 2015), who argues that viruses should not be seen as just pathogens, because in fact they are often beneficial to their hosts in ways that sustain life as we know it.  Viruses are often critical symbiotic partners in the health of their hosts.  For example, the gastrointestinal tracts of mammals--including humans--are full of viruses (as well as bacteria), and they probably have important functions in their mutualistic interactions with their hosts.

Behe's reasoning, therefore, seems to be that the intelligent designer could have designed the general structure of viruses and the mechanisms of mutation so that viruses can serve some vital functions in nature, and so viruses are generally good, which was the intention of the designer.  But the natural process of random mutation can create viruses like COVID-19 that are deadly to human beings, which is a bad outcome that was not intended at the beginning by the intelligent designer.

Does this allow the religious creationist to see the coronavirus as an evil product of nature in a world that was created by an all-good intelligent designer?

Notice that Behe concedes that the COVID-19 virus can be explained fully as a product of Darwinian evolution that does not require the intervention of the divine intelligent designer in nature.  The designer of the COVID-19 virus is evolution by natural selection working on random genetic mutations not God!

In The Edge of Evolution, Behe makes it clear that while he believes that intelligent design is required to explain the emergence of the higher taxonomic levels of life--kingdoms, phyla, classes--Darwinian evolution explains the lower levels--order, families, genera, and species.  So the evolution of the human species from common descent from primate ancestral species is fully Darwinian.  Similarly, the evolution of viruses is by Darwinian evolution.

Although Behe seems to reject "theistic evolution" in two passages (210, 229), he generally seems to accept it, because he assumes that once the Intelligent Designer created kingdoms, phyla, and classes and set in place the general laws of nature at the beginning of the universe, He did not intervene into nature after that.

Consider, for example, the following passages.  "The possibility of intelligent design is quite compatible with common descent, which some religious people disdain.  What's more, although some religious thinkers envision active, continuing intervention in nature, intelligent design is quite compatible with the view that the universe operates by unbroken natural law, with the design of life perhaps packed into its initial set-up" (166).  "The purposeful design of life to any degree is easily compatible with the idea that, after its initiation, the universe unfolded exclusively by the intended playing out of natural laws.  The purposeful design of life is also fully compatible with the idea of universal common descent, one important facet of Darwin's theory" (232).

This allows Behe to say that the Intelligent Designer bears no moral responsibility for the evil of the COVID-19 pandemic, because this virus arose not by the intervention of the Intelligent Designer but by natural Darwinian evolution.

Houses of worship have been closed to large religious meetings because of the pandemic.  When they reopen, and religious believers survey the death and destruction inflicted by the pandemic, will it be possible for the preachers to use this reasoning to say that God cannot be blamed, because He was unable or unwilling to intervene in nature to prevent the evolution of the COVID-19 virus?

Will the preachers also say that the Intelligent Designer allowed this to happen to teach us that preserving our mortal life in this world is less important than securing our immortal life in the eternal world to come--Heaven or Hell?

One of the leading medical scientists in the American government directing the response to the COVID-19 pandemic is a devout Christian--Francis Collins, the Director of the National Institutes of Health--who is a theistic evolutionist.  I wrote about Collins (here) when he was first appointed by President Obama.  As influenced by the theistic evolutionism of C. S. Lewis, Collins sees no conflict between evolutionary science and Christian faith.  He thinks science can be a form of worship insofar as it means studying the wondrous work of God's mind in nature, which includes God's working through the natural evolutionary process.  And he thinks scientists should respect theistic faith as a way of answering ultimate questions about the meaning and purpose of human life in the universe that are beyond science.

Peter Wehner has an interview with Collins at The Atlantic website.  There is one point in the interview where Collins intimates how his faith helps him to face up to the sufferings of life like the COVID-19 pandemic:
"I think I've also arrived at a place where my faith has become a really strong support for dealing with life's struggles.  It took me awhile, I think--that sense that God is sufficient and that I don't have to be strong in every circumstance.  One of my great puzzles when I first became a Christian is that verse [Second Corinthians 12:8-10], 'My grace is sufficient for you, because My strength is made perfect in your weakness.'  That was so completely upside down for me.  Weakness?  And now I embrace that with the fullness of everything around me when I'm realizing that my strength is inadequate, whether its coronavirus or some family crisis, God's strength is always sufficient.  This is such a great comfort, but it took me a long time to get to the point of really owning that one."
He also says that as a young man, his atheism was challenged when he was a third-year medical student, and he began treating patients who were dying, whose faith sustained them: "Many of these people were deeply committed to faith.  I was puzzled and unsettled to see how they approached something that I personally was pretty terrified about: the end of their lives.  They had peace and equanimity, and even a sort of sense of joyfulness that there was something beyond.  I didn't know what to do with it."

Collins founded the organization BioLogos to promote the idea that science and Christianity are compatible.  Recently, the folks at BioLogos have been producing podcasts and blog posts on the coronavirus pandemic exploring how the evolutionary science of viruses can help Christians see how the evil of the coronavirus pandemic can be reconciled with their belief in God as the good and loving Creator of nature.

Jim Stump, Vice President at BioLogos, has written an essay on "Coronavirus and the Problem of Evil."  If God is good, benevolent, and omnipotent, Christians might ask, why doesn't He protect us from evils like this pandemic?  Stump's answer is the one suggested, but not fully elaborated, by Behe:  God does not intentionally design natural evils like viral pandemics, which actually arise as unavoidable side effects of the naturally good world that God has created.

Traditionally, as Stump indicates, some Christians have solved the problem of natural evil by saying that it's a consequence of the Fall.  Adam and Eve were created by God to live in a naturally good world, but when they yielded to the temptation of the serpent in the Garden of Eden, they sinned, and God's curse on them for their sin included a curse on nature, so that human beings would henceforth suffer and die from natural threats to human life, including deadly viruses.

I agree with Stump that this fails for two reasons.  First, the punishment doesn't fit the crime: extending the curse on Adam and Eve to include a curse on all of nature for the rest of human history on earth seems excessive.  The second problem is that evolutionary science leads us to believe that viruses came into existence millions of years before the first human beings.  (I have written about reconciling Adam and Eve with evolutionary science here and here.)

Stump proposes a better way to solve the problem of natural evil.  The theistic evolutionist can argue that God has chosen to use the natural processes of evolution to create a good world that sustains human life, but these generally good conditions for life have unavoidable side effects that are bad.  Viral pandemics illustrate this.  Human life as we know it would be impossible without viruses.  Most viruses on Earth are infecting bacteria and thus slowing down their reproduction, so that rapidly reproducing bacteria do not overwhelm us.  But for viruses to do that, they must mutate rapidly, and that rapid mutation can sometimes create viruses--like COVID-19--that are dangerous to human beings.  Evolution creates trade-offs in which we have to take the bad with the good.

We should also see that the same evolutionary process that creates dangerous viruses also endows human beings with the intelligence and motivation for scientific understanding of viruses and viral epidemics that can teach us how to fight those viral threats to human life, which is what we are trying to do now.

I have written about intelligent design theory, scientific creationism, and theistic evolution herehereherehere, and here.

I have written about Heaven and Hell here and here.


REFERENCES

Roossinck, Marilyn. 2011. "The Good Viruses: Viral Mutualistic Symbioses." Nature Reviews Microbiology 9 (February): 99-108.

__________.  2015. "Move Over, Bacteria! Viruses Make Their Mark as Mutualistic Microbial Symbionts." Journal of Virology 89 (13): 6532-6535.

Thursday, March 19, 2020

The Foolishness of the Coronavirus Panic and Trump's Economic Shutdown: A Darwinian Evolutionary Analysis

Is it reasonable to be thrown into a state of panic by the spread and virulence of the COVID-19 virus?  Does this justify a massive shutdown of the global economy as proposed by Trump and other political leaders?  A Darwinian evolutionary analysis of the coronavirus epidemic suggests that the answer to both questions is no.

My reasons for this conclusion have been summarized by various commentators--particularly, John Ioannidis and Richard Epstein.  Epstein has stated his reasoning in an video interview at Reason magazine.

At Trump's press conference on Monday afternoon, he announced the establishment of what might be called the Coronavirus Administrative State as recommended by a White House task force.  This would include economic lockdowns and business closings like those already ordered by mayors and governors in many American states and cities.  When Trump was asked how long this would be required, he said it might last until July or August.  This was a lie, because as indicated by later reporting here and here, the White House has already written out a plan for locking down much of the American economy for at least 18 months, which is in response to warnings from a team of epidemiologists at Imperial College London arguing that this is the only way to avoid massive global deaths from the virus--including 250,000 deaths in Great Britain and 1.2 million deaths in the U.S., or even twice that if the epidemic is not mitigated at all.

If you read that Imperial College study, you will see that it's based on a mathematical model that assumes a "reproduction number" (R) of 2.4 and an "infection fatality ratio" of between 0.25% and 1.0%.  A 2.4 reproduction number means that every person infected will pass the infection on to an average of 2.4 people, which creates an exponentially growing rate with a doubling time of 5 days.  An infection fatality ratio of 1% means that on average 1% of the people infected will die.  With these parameters, it's a simple mathematical exercise to project one or two million deaths in the U.S. and hundreds of millions around the world.

But do the existing data about the CORVID-19 epidemic and what we know about the evolution of viruses and of human behavior in response to deadly viruses support the assumptions behind this simple model?  The authors of the Imperial College study hardly ask much less answer this question.  The same can be said about similar studies, such as the essay by Tomas Pueyo that I cited in my previous post.

Consider the replication rate of 2.4.  This assumes that human beings will not respond to the epidemic in adaptive ways to slow down the replication.  That is, of course, a false assumption.  During the early stages of the spread of a disease, most people will not take precautions against it, because they are unaware of the danger.  But as soon as people learn about an epidemic and learn that they can reduce it by washing their hands, by "social distancing," and by isolating infected individuals and those most susceptible to deadly infections, they do so; and this reduces the replication rate.

Sometimes the replication rate for infectious viruses varies according to the seasons of the year.  One study of the coronavirus epidemic suggest that the pattern of the epidemic in China shows that the epidemic slows down when the temperature and humidity is high.  So it's possible that the epidemic could be slowed down in the Northern  Hemisphere by the coming of warmer spring and summer weather.  But other researchers dispute this.

A fixed replication rate of 2.4 ignores the fact that the most vulnerable people are hit first, and therefore replication will go down as the remaining pool of people is more resistant to infection.

A fixed mortality rate of 1% ignores the fact that viruses vary in their virulence, and that the most virulent viruses can be eliminated by natural selection.  As long as human beings are ignorant of the epidemic and not taking precautions against it, the most deadly viruses can reach their next victims before killing its host.  But once people adapt to slowing down the transmission of viruses, the most virulent viruses will kill their hosts before they have a chance to spread.  The weaker viruses will survive and reproduce at a higher rate than the stronger viruses, and consequently the viruses will become less severe by natural selection.

The mortality rate in an epidemic also often varies according to age groups.  In this case, the mortality for the coronavirus is much higher for the elderly--and particularly those with preexisting health problems--than for other age groups.  Some of the data indicate a fatality rate of 9.51% for those 80 and above, 5.33% for those 70-79, as opposed to 0.12% for those 30-39 and 0.09% for those 40-49.  That explains why the highest death rates have been in old age care facilities and in countries like Italy that have aging populations.

The conclusion from all this is that the most evolutionarily adaptive response to the coronavirus epidemic would be to isolate the most vulnerable groups--particularly, those over 70 with health problems.  But there is no reason to shut down large parts of our economy to protect younger, healthier people.  To do that--as Trump and others have started to do--will create more harm than good--the lives and livelihoods of hundreds of millions of people will be ruined.  Countries like South Korea and Singapore have brought the epidemic under control with massive testing and isolation of infected individuals, but without shutting down their economies.  That's the prudent policy.

There is an issue in political philosophy at stake here.  Some social commentators have said that the need for governmental suppression of economic activity to deal with the coronavirus pandemic shows the flaws in liberal political theory, because it shows that in times of emergency threats to human life, we have to sacrifice individual liberty and property rights for the sake of governmental intervention to protect public health.

That argument is false both in its interpretation of liberal political theory and in its assessment of the best public policy for the epidemic.  First, as Epstein observes, it overlooks the fact that liberal political theorists have always recognized that in time of emergencies when human survival is at stake, "the safety of the people is the highest law," and government must act to temporally set aside the normal laws of liberty and private property: "property rights are suspended in times of necessity, but only as long as the necessity lasts."

In this case, however, the necessity is not clear enough to justify the sacrifice of liberty and property for security.  In this case, the extreme measures for shutting down much of the economy would not serve the public good.

If John Locke is right that human beings have natural rights to life, liberty, and property; that they will consent to government as long as it secures those rights; but that when government infringes on those rights, they have the natural right to the "executive power of the law of nature" allowing them to rebel, then we might predict that as people see that their governments are threatening their lives, liberty, and property by shutting down economic activity in ways that are unnecessary for handling this epidemic, then people will engage in civil disobedience.  For example, how long will it be before owners of bars, restaurants, and other businesses shut down by government defy the closure orders and open up for business?

In the U.S., Trump hopes that mailing out checks for a few thousand dollars to Americans will prevent civil unrest.  How likely is that to work as the months go by, and more and more people invoke their natural right to rebel?

Saturday, March 14, 2020

The Evolutionary Psychology of Coronavirus and the End of the Trump Presidency


On January 22, speaking about the threat of the coronavirus, President Trump said: "We have it totally under control."  Two days later: "It will all work out well."  On February 28, speaking about it at a campaign rally: "It's going to disappear.  One day, it's like a miracle, it will disappear."

An article in the Washington Post chronicles the 19 times that Trump has downplayed the danger of the coronavirus pandemic.  Now Trump's foolishness is evident.

Even if you think he was right to suggest that the coronavirus pandemic is unlikely to be much more deadly than the yearly flu epidemic, then you would have to say he is foolish in changing his mind without giving any good reasons.

Here's a good global map of the pandemic.  The Lancet has a website with the latest published research.

Tomas Pueyo has written a helpful analysis of the data showing that the coronavirus is spreading exponentially in the U.S. and elsewhere.  Some of Pueyo's data charts are reproduced in an article in the London Daily Mail.  Most important for his paper is "Chart 7: Timeline of Events in Hubei," which shows how the growth of coronavirus cases began to increase exponentially--doubling everyday--until the Chinese imposed a total lockdown, after which new cases began to decline.  He shows that many Asian countries--Japan, Taiwan, Singapore, Thailand, and Hong Kong--have flattened the growth rate to avoid the exponential explosion because they acted quickly based on the lessons they learned from past epidemics.

But it's now too late for the U.S. and countries in Europe to avoid that explosive growth, and all of these countries will face the catastrophe that the Italians are facing today.  Within a few weeks, much of the world will probably be forced into a lockdown.

Peter Wehner has written an article for The Atlantic arguing that this delay in the American response to the coronavirus danger means the end of Trump's presidency, because the failure of the Trump administration to handle this crisis exposes the moral, intellectual, and temperamental unfitness of Trump for public office.

This is also a reminder of the long evolutionary history of human vulnerability to deadly parasites and of the moral, political, and scientific efforts required to understand and mitigate that threat to human life and civilization.  I have written previously about Lucretius' evolutionary understanding of the plague in Athens (here) and Darwin's understanding of the microbial threat to human life (here).

Evolutionary science explains coronavirus and other parasites as organisms that have evolved adaptations for exploiting their hosts in ways that facilitate their reproduction.  So, for example, that's why coughing and sneezing are common symptoms for viral illnesses: if a virus causes its host to cough and sneeze when its host is close to other potential hosts, this increases the likelihood that the virus will replicate itself.  So viruses and other parasites are designed by evolution to alter the behavior of the host for the benefit of the parasite, which is often costly for the host--even to the point of death.

But a really smart virus will not be too deadly, because if its too deadly, it kills the host before the host can transmit the virus to another host.  The Ebola virus is so deadly--90% fatality rate--that it kills so many of the hosts so quickly that the virus does not replicate itself as widely as the coronavirus--with a fatality rate of only 0.5% to 4%.

Here's the point where we should remain rightly skeptical about the coronavirus panic.  So far, there is no clear evidence that the fatality rate for the coronavirus is much higher than for the yearly strains of flu.  Higher fatality rates based on reported cases are surely wrong, because many of the people infected by the virus do not realize they have it, and so they are not being counted.  It is clear that almost all of the deaths are among older people with preexisting health issues that make them vulnerable.  If the true death rate for coronavirus is similar to that of a severe seasonal flue, then it will be below 1%.

There is some evidence that when people contract the flu virus, but before their symptoms appear, the contagious people are more inclined to social activity--visiting people and going to social events--so that they are more likely to transmit the virus to others.  It's possible that the coronavirus does this.

Once we have this evolutionary understanding of how viruses are adapted for parasitic exploitation of hosts, we can devise strategies for countering their threats.  So, for example, we can tell people to wash their hands multiple times a day and to practice "social distancing"--staying at least six feet away from others--so that the transmission of the virus is less likely.  We can also develop elaborate public health measures for tracking and slowing the spread of the virus around a community or even around the world.  And with the microbiological understanding of how viruses work, we can devise vaccines against them.

The main philosophical lesson from this is that the universe does not care for us the way we care for ourselves, and so we must use our scientific and political knowledge of and power over the natural world to create an ecological niche for ourselves that is hospitable to human life and well-being.

To succeed in that, we must not elect to high public office people like Trump who lack the fitness for serving that human project for protecting human life in a universe that is indifferent or even hostile to our human concerns.

The blame here is not restricted to Trump and the executive branch.  Early Saturday morning, the House of Representatives passed a coronavirus relief bill, even though the congressional representatives saw the final revised bill of 110 pages only 30 minutes before they voted on it!  Justin Amash--my congressman for the 3rd Congressional District of Michigan--refuses to vote for any bill that he has not had the time to read.  So he voted "present."  He rightly argues that this illustrates how the Constitution has been thrown out by both parties.  The Congress no longer deliberates about legislation, because legislation is written by the congressional leadership (Pelosi and McConnell) with the approval of Trump.  The other members of the Congress hardly even know what's in the legislation.  This is Rule by the Swamp as opposed by constitutional government.  Amazingly, many of the intellectual supporters of Trump claim to be defenders of the Constitution.

I have written Amash as perhaps unique in his constitutionalism here and here.

I must conclude this post on a note of uncertainty because, as I have already indicated, deciding whether it is reasonable to put our societies into lockdown to reduce the coronavirus infections depends on our estimate of the fatality rate.  The crucial point in Pueyo's paper is where he concludes that while "countries that are prepared will see a fatality rate of 0.5% (South Korea) to 0.9% (rest of China," "countries that are overwhelmed will have a fatality rate between 3% and 5%."  What he means by "overwhelmed" is that countries that do not quickly go into lockdown will allow the number of infected people to rise so greatly that the number of people needing intensive hospital care will so overwhelm the hospital system that many will die because they will not receive the care necessary to save their lives.  There are reports that this has happened in Italy.  The unanswered question is whether this is true or not.  That's the question behind this graph: