COVID and Learning From Our Imperfection.

Human beings are an evolved but imperfect species. We have cognition and a richer inner life but this does not make us stronger or more adaptable. We remain more of the natural world than our iPads might suggest.

The human immune system separates two worlds, the outside of us and the inside, carefully shielding one from each other. We employ elegant sampling mechanisms controlling when we respond and with how much physiologic fervor. COVID is an interloper that was not immunologically “ learned” in childhood. Some people let in too much virus while others respond too strongly. Species vs. species is an age-old drama.

Humans are less likely to survive across the eons than the turtle or the roach. Artificial Intelligence meets its match in Nature’s indifference. It is our consciousness that perceives the irony of our frailty.

Humans carry billions of resident bacteria and viruses. The interface between species is now recognized as a critical part of the mechanisms of disease. From colon cancer to multiple sclerosis, it may be the non-human part of us that modulates our risks.

When COVID stuck, it came at a moment when we had misplaced a bit of humility. Farmers always bowed to the rain, sailors to the wind. We expect solutions to be an app click away. When they are not, there must be fault, in a person or in a process that is delaying the assuaging of our fears. Previous societies sought to placate its angry gods; we masked ourselves, ran to our caves, and ordered Rocky Road.

We had become as used to good health as were previous generations to death. A hundred and fifty years ago, half of all households lost a child or mother at birth. COVID was a new virus but, in reality, an old song. A disease will find a weakness or the weak. We are an unwilling host for a determined traveller.

Illness can still provide a path towards empathy. A labored breath, heard a room away, does not reveal race, wealth nor which God, if any, is being called. This is not the last time we face the folly of our divisions but just the first opportunity in a while. COVID is not a race or class issue, it is a cold-hearted challenge to our species.

Our vulnerability is universal and perpetual. Our mutation rate to self protect is far slower than the viral mutation rate to harm. The virus does not cause the clinical illness; it triggers and encourages both the strengths and flaws of our immune system. Too much response, kills the host, too little, protects the invader.

Truth be told, despite the vaccine directed to the spike protein to limit the amount of virus taken into our cells, the capability of our long term memory T cells to prevent reinfection is still unknown. Uncertainty was the bedfellow of the past and is with us again.

Many who have recovered will tell you that the feeling of weakness was so profound as to challenge the essential will to survive. It is a primitive memory and transcends all of the ways we have imagined that each of us is different from the other. Biology is a constant and politics the variable. A master teacher is educating us.

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Professor of Medicine , essayist, practitioner, basic research and education ; reflections on medicine and modern society

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Joel B. Levine MD

Joel B. Levine MD

Professor of Medicine , essayist, practitioner, basic research and education ; reflections on medicine and modern society

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