As most parts of the world reached the end of the second month of lockdown on May 8, 2020, the United States and nations across Europe celebrated the 75th anniversary of V-E Day. Despite restrictions on gathering, communities honored the massive collective sacrifices made to defeat the Axis forces with the laying of wreaths, the piping of bagpipes, and the playing of 1940s music at socially distanced parties. Many drew historical parallels between our current global crisis and the one sparked by World War II. They looked back in time for inspiration and for models of solidarity. As I listened to the reporting, I found myself dreaming about what massive gatherings and parades might look like when we have a vaccine, and declare victory against Covid-19.“An “us” versus “them” mindset engendered by the metaphor of war focuses our attention on viruses, vaccines, and victory.”
Yet, as much as it allures, there are significant dangers to traveling too far down this imaginative path. An “us” versus “them” mindset engendered by the metaphor of war focuses our attention on viruses, vaccines, and victory. It leads us to believe that there is a discrete enemy out there—a virus—that we must defeat. Yet, as we focus on this so-called frontline, we risk missing the deeper, more systemic problems. All our efforts, staying home and holding the frontline, may only lead us into the next battle, if we do not attend now to the unraveling of relations that sustain trustworthy truths—the veracity required to live collectively.
Veracity derives from the Proto-Indo-European (PIE) root were-0, meaning true, trustworthy. It joins truth and trust, highlighting that one cannot be had without the other. Creating this veracity—trusted truths that can guide us through this crisis—requires a relational conception of who we are that does not pit humans against viruses, or humans against other humans. It necessitates stepping back from the imaginaries of isolation and containment to muster the courage to craft language and practices that recognize and respond to our interdependencies. If we are to foster survival and cohabitation on this planet with not just our fellow humans, but all our companion species1Chicago: The University of Chicago Press, 2003More Info →—including viruses—then building veracity must become as urgent as creating a vaccine.
The historical origins and dangers of “fighting disease”
This will not be easy. For centuries, human beings have scripted diseases as unicellular enemy combatants. War metaphors—as historians of medicine such as Angela Creager,2Chicago: The University of Chicago Press, 2001More Info → cultural critics like Susan Sontag,3Susan Sontag, Illness as Metaphor and AIDS and Its Metaphors (New York: Farrar, Strauss and Giroux, 1978). and Rebecca Herzig and Lochlann Jain,4Rebecca Herzig and Lochlann Jain, “Commentary: Surviving Terrorist Cells,” Academic Medicine: Journal of the Association of American Medical Colleges 84, no. 1 (2009): 11–12. have alerted us—are endemic to how we talk about disease. In the United States, these metaphors sedimented in collective imaginaries during the wartime presidency of Franklin Delano Roosevelt. Roosevelt had polio and brought national attention in the United States to biomedical research, launching important philanthropic efforts, like the March of Dimes. The eventual creation of the polio vaccine in 1955 was a monumental medical achievement, one likened to winning the war against the Axis forces, a cause that Roosevelt also championed.
Today, we hear this war metaphor all around us. Recently, a retired British colonel, Tim Collins, announced to the British public on the BBC: “This is a war. This is a war with an alien, an alien thing.” He had, of course, only the best of intentions. Like so many political and military leaders before him, he sought to unite a nation against an enemy outsider. Yet, likening Covid-19 to an enemy combatant is likely to injure more than it saves. This will happen—despite our best efforts—unequally, targeting our most vulnerable. Regardless of efforts to stress that we are only at war with the virus, inevitably the war spreads to those associated with it. Our histories are littered with analogous examples. As too many of us can attest, countless have lost their lives not due to infection by the Human Immunodeficiency Virus (HIV), but rather because of the stigma that society still attaches to the virus. Thousands more currently suffer anti-Asian violence and hate as Donald Trump insisted early in the pandemic on calling Covid-19 the “Chinese virus,” and still argues that the virus originated in a lab in Wuhan. Nonhumans—bats and the pangolins recently identified as the likely secondary hosts of SARS-CoV-2 (the virus that causes Covid-19)—also face vilification.
The war metaphor also places the virus as the thing that matters in this moment, that which we should all be fighting. Yet, should Covid-19 be such a thing? As Bruno Latour reminds us, thing comes from the old Norse word ding, which means parliament—a gathering in which we decide about things that matter to us, and form objects of our concern. These objects, as Sara Ahmed alerts us,5Durham, NC: Duke University Press, 2006More Info → orient us. Making the coronavirus the thing around which we gather orients us toward reductionism and destruction. Our collective energies turn toward testing, excising, and eradicating a microscopic bit of RNA. We practice the arts of segregation as we isolate not only ourselves, but our mail and our groceries. In so doing, “we” are diminished.“Health crises and deaths not officially due to Covid-19, but that might have been prevented, also moved to the sidelines.”
The death counts offer a prime example. We all have our eyes on them. They lead press briefings as governments mobilize to build our resolve to stay home and fight the virus. As this happens, the illnesses and deaths of many fall from view. For many weeks, only those happening in hospitals—not nursing homes or other sites of care—made their way into the official counts in the United States and across the world. Health crises and deaths not officially due to Covid-19, but that might have been prevented, also moved to the sidelines. My mother, for example, slipped and fell and hit her head during the second week of April. Because of Covid-19, she first was taken to an urgent care plus facility, rather than the main hospital. We will never know if her life could have been saved had she gone straight to an intensive care unit (ICU). There will be no accounting. While there is a powerful relationship between Covid-19 and all illnesses6Kamal S. Saini et al., “Effect of the Covid-19 Pandemic on Cancer Treatment and Research,” The Lancet Haematology 7, no. 6 (2020): E432–E435. and deaths, understanding Covid-19 as a thing we are at war with shrouds these relations, and constricts our capacities for care.
The urgency of trust
Like death counts, testing also too narrowly focuses our attention. Yes, we desperately need greater capacities to test. However, even more than this, we need to solve the problems that led to the testing shortage in the first place, and which—if left unaddressed—will undermine the effectiveness of scaled-up testing regimes if and when they become available. In the early days of this pandemic, US government officials understandably turned to the Centers for Disease Control and Prevention (CDC), as one of the world’s premier public health institutions, to create a Covid-19 test. Yet, as widely reported, failure to follow protocols produced a flawed, contaminated test. While the precise reasons remain unclear, persistent underfunding of the CDC, combined with leadership by Robert Redfield, someone with little public health experience who during the AIDS crisis rejected medical norms in favor of discriminatory conservative religious beliefs, hampered the institution and its credibility at a critical moment. The consequences have been dire, undercutting testing capacities and the trustworthiness of the CDC at a time when both are desperately needed.
Institutions and laboratories that today attempt to fill the gap will need to pay careful attention to building trust. Creating reliable, uncontaminated tests will be important, but will not suffice. Even if convinced of the accuracy of tests, the recent rise in concerns about the use of DNA tests to surveil ethnic minorities will lead some to hesitate before allowing a swab of their nose. Human DNA inevitably will be collected along with any viral RNA, producing questions about the uses and handling of this personal genetic material. When testing is linked to research, institutions should be prepared to answer questions about the interests served, especially when there are corporate partners. As in other areas of genomics research, attempts to mobilize the tools of genetic analysis to understand the transmission, spread, and evolution of Covid-19 will blur the lines between research and medical care,7Benjamin E Berkman, Sara Chandros Hull, and Lisa Eckstein, “The Unintended Implications of Blurring the Line between Research and Clinical Care in a Genomic Age,” Personalized Medicine 11, no. 3 (2014). creating tensions between a physician’s fiduciary duty to act in the best interest of their patients and a scientist’s duty to advance research. Managing and carefully addressing these tensions will be critical to creating and maintaining trust in tests.“Linking Covid-19 testing to race and ethnicity in a manner that leads some groups to be perceived as more susceptible to the disease could undermine the ability of these groups to participate fully in post-lockdown Covid-19 society, thus creating understandable resistance to testing.”
Careful consideration also should be given to what information is collected along with the Covid-19 test biospecimens. Notably, while racial and ethnic information may help illuminate disparities, it also may lead to stigmatization and promote ungrounded biological theories of disease transmission that promote an “us” vs. “them” mindset. Linking Covid-19 testing to race and ethnicity in a manner that leads some groups to be perceived as more susceptible to the disease could undermine the ability of these groups to participate fully in post-lockdown Covid-19 society, thus creating understandable resistance to testing. A focus on the technical and practical development of tests (e.g., availability of swabs, contamination problems) too easily averts attention from these broader relations and dynamics that shape capacities to turn tests results into the trustworthy truths—the veracity—needed to make them effective guides of individual and collective action.
Over the edge into the pandemicene
Focusing on these munitions needed for the “frontlines”—not just tests, but vaccines—averts our attention from all the care needed outside official public health settings to keep the world, in all its relations, well. As we have learned over the last two months, elderly people who face challenges getting food, incarcerated persons who have lost in-person visitations and educational opportunities, minority-owned businesses that face difficulty enrolling in the Payment Protection Programs, students returned home who confront difficult family environments, and so many more all require our recognition and support. Care is needed too not just for our ICU nurses and doctors, but for our personal home healthcare attendants whose needs for PPE were overlooked for far too long in this pandemic. Critically, care also is needed, as Donna Haraway has powerfully argued, far beyond the human world.8University of Minnesota, 2007More Info → This pandemic makes amply clear that all lives are imbricated. When we cut down forests, we destroy habitats that keep disease-transmitting organisms, such as mosquitos, in check. When we decrease biodiversity, we destroy the buffer between humans and microorganisms, making us more vulnerable to disease like Lyme disease and the bacteria that causes it, Borrelia burdorferi.
Ignoring these relations for decades—centuries—has not just produced a pandemic, it has pushed us over the edge into a pandemicene, a boundary event in which there is no going back.9Donna Haraway, “Anthropocene, Capitalocene, Plantationocene, Chthulucene: Making Kin,” Environmental Humanities 6, no. 1 (2015): 159–165. Ongoing planetary plundering has left our relations with the other great planetary terraformers, bacteria and viruses, fundamentally off kilter. Centuries of racism and structural inequality have left too many without housing in which to shelter in place, and even, on the best of days, the right to breathe.10Lindsey Dillon and Julie Sze, “Equality in the Air We Breathe: Police Violence, Pollution, and the Politics of Sustainability,” in Sustainability: Approaches to Environmental Justice and Social Power, ed. Julie Sze (New York: NYU Press, 2018). Nothing makes our collective fall more painfully palpable than the recent murder of George Floyd, and the shredding of our polity it reveals and amplifies.
It is no longer possible—if it ever was—to believe that the world’s ills will be solved the day we have a vaccine, the V-day of our times. The problems we face are far more systemic and enduring. Addressing them requires acknowledging deeper truths. Responding to them requires facing what Kimberlé Crenshaw has described as the “bone-chilling” truth that Black Americans have died disproportionately during this pandemic because of the “everyday disregard” for their lives. It requires understanding that too many of our institutions are ir-responseable;11Ir-response-able, as I use it, is inspired by Donna Haraway’s notion of reponse-ability, a reworking of responsibility as the ability to respond. See Donna Haraway, “Awash in Urine,” Women’s Study Quarterly 40, no. 1–2 (2012): 301–16. that is, they fail to respond to the needs of large majorities, eroding both care and trust.
Harnessing the power of Covid-19“Now is the time to reorient—this time not around a virus, but all the relations that brought that bit of RNA to our attention.”
The coronavirus is merely a single strand of RNA, but it may be the most powerful sociological and ecological tool yet. Over the last few months it has shone a powerful light on ecosystem vulnerabilities and fractures in modern societies. It has sharpened minds and amplified a collective sense of urgency. This presents us with an unprecedented opportunity. Now is the time to reorient—this time not around a virus, but all the relations that brought that bit of RNA to our attention. Now is the time to place an understanding of those relations at the heart of our best efforts to know the world—to recognize, as Ruha Benjamin calls us to, that a narrow interpretation of data not only conceals, it kills. Now is the time to mobilize this deeper, broader, and thus more trustworthy understanding to re-imagine and recreate all of all our institutions—from public health to public education to the public enforcement of the law—toward justice.
Six feet or six thousand miles apart, we have the opportunity of a lifetime to build together situated, trustworthy truths that recognize our relations with others, and provide the foundations for a better world. Surviving and eventually living well in a pandemicene depends not on a vaccine that can defeat a virus, but on our embrace of this opportunity to create together the veracity required to imagine and sustain collective life.
Banner photo credit: Tim Dennell/Flickr