First responders remove crew members with flu-like symptoms from a cruise ship at the Port of Miami in Florida, March 26 (Photo: Getty Images)
Given that all of us are programmed to believe that ‘science’ will bring us the ‘millennium’, it may be a little counterintuitive to suggest that it doesn’t have all the answers. But look at the reality: a stealthy global pandemic is killing thousands, that too, in gruesome ways where their lungs get destroyed, and yet all our gleaming, well-funded labs and white-coated scientists have practically nothing with which to help them, much less cure them.
All that science tells us lay people is: Try not to get infected. Because if you do, you are on your own. You’ll live if your body can deal with it. Good luck! Oh, and wash your hands.
That (minus the hand-washing) is exactly what doctors must have told patients during Europe’s Black Death around 1350 CE. It is staggering that, after 650 years of spending gargantuan amounts on medical science, Western medicine (pretentiously also known as ‘modern medicine’) literally cannot help you, and all bets are off.
In other words, today’s patients are as helpless as those who died of the bubonic plague epidemic, despite the fact that improvements in personal hygiene and community waste management have had a large effect on public health. Yet, progress has not been smooth: it’s by fits and starts; and now may be one of the down periods.
Hygiene and antibiotics have been the crown jewels of Western medicine for 80 years. But with the rise of antibiotic-resistant bacteria, the day may not be far off when we will have no weapons against bacteria either, not only against viruses. If so, we would have regressed to the days before Pasteur and Lister, when going in for surgery meant your odds of survival were 50:50. Pure chance, entirely dependent on your luck and your immune system.
There is the sad story of the British policeman who was the first person to be treated with penicillin in the 1940s. He was scratched on his face by a rose thorn, and the wound went septic. He was seriously ill; antibiotic treatment helped, but then they ran out of penicillin, and he died. This is the fate that might await billions if no new antibiotics are created.
Let us also, with gratitude, remember Ignaz Semmelweis, the Viennese doctor who suggested in 1850 that obstetricians washing their hands would reduce the incidences of deaths of women who had just had a baby. He noticed that doctors were going directly from autopsies to deliveries without washing their hands; and he figured they were carrying infections. However, for his pains, he was mocked, put in a lunatic asylum, and beaten to death by the guards.
Semmelweis’ tragic tale has a deeper meaning: science, contrary to the public imagination, is not about the unstoppable march of pure rationality. Max Planck, the famous physicist, said science advances “one funeral at a time.” That is, famous scientists who are invested in their current theories will never change their minds and will do their best to suppress any heresies; but as they pass away, new ideas gain currency.
A good example is Galileo Galilei and the astronomers of the Vatican. The latter had staked much of their lives and their reputations in complex epicycles and other artifices to explain the observed movements of planets under their earth-centric theory. They were not about to let that upstart Galileo destroy their life’s work with his heliocentric absurdity. They were prepared to burn him at the stake if he didn’t recant.
Academic scientists are not dispassionate seekers after some abstract truth; they too have their pet theories, fads and petty jealousies. For instance, recent unedifying battles between the University of California, Berkeley, and the Broad Institute, Cambridge, Massachusetts, over US patents for CRISPR-Cas9 gene editing show that prestige, Nobel Prizes and large stock options are part of the picture, and that scientists are only human.
Besides, Western science has traditionally been mechanistically Cartesian, looking at the human body as a machine. Cartesians also believe (among other things) that dividing something up to the smallest particle can help explain everything about behaviour at the gross level.
That this approach is insufficient is quite clear from the fact that Cartesians cannot even define what life is, because there is no room for consciousness in their model. They punt, for instance, on whether viruses are alive. To a layman, viruses are biologically active, they have RNA, they have a sense of purpose (invasion and reproduction), but a Western scientist hedges.
This view is absurd. Among other lacunae, it ignores emergent intelligence, where the whole is indeed greater than the sum of its parts. An individual ant is a rather unremarkable creature, but an ant-hive exhibits a degree of intelligent behaviour. The same is true of bees, birds and humans. So where does the ‘wisdom of crowds’ come from? Cartesians don’t know.
Maybe, the much-touted ‘herd immunity’ strategy that the UK, for example, followed regarding coronavirus (Covid-19), is somewhat similar: the idea that a community develops overall immunity after many individuals have survived the illness. Interestingly, this also smells of Utilitarianism, the greatest good of the greatest number, inconvenience to individuals be damned. Which may be a reasonable perspective.
The question of consciousness is not a purely abstract matter, because as machines become artificially intelligent, there may be a time when they suddenly become self-aware. Scientist-philosopher Subhash Kak believes that machines will never acquire consciousness, but we don’t know that yet.
To give credit where it is due, Western science does have the Heisenberg Uncertainty Principle, which suggests that it is impossible to know things precisely beyond a certain level; the mystery of quantum behaviour where, in effect, it is possible for two quantum-entangled particles to show ‘action at a distance’, thus implying travel faster than the speed of light, is another example. Nature is going to hold on to her secrets, after all.
The problem with the Wuhan coronavirus is that despite all the ivory towers of science, not much is known about the disease. It has been around for at least three months, yet nobody can answer a few questions: How is it inherently able to attach itself to the ACE2 receptor in human lung cells unerringly, whereas other viruses have to mutate to get there?
Is this an engineered bioweapon, or is it a natural mutation that jumped from a host animal to humans, possibly through the wet market in Wuhan? Why does its surface spikes carry distinctive HIV-like proteins that make it more virulent? (The IIT Delhi preprint paper that asserted this was man-made was withdrawn after being attacked severely on social media).
Does the virus spread through the air? How does it infect young people without sickening them? Can you tell without testing if you are an asymptomatic carrier? Is BCG vaccination (for tuberculosis, which many in developing countries are routinely administered as a child) a factor in immunity? Do viral medicines Remdesivir or HIV drugs Lopinavir and Ritonavir actually work? What about interferon? Is a combination of Azithromycin plus Hydroxychloroquine a safe prophylactic? When will there be a vaccine for the virus?
How come Wuhan in China was badly affected, but nearby Beijing and Shanghai were not? Do the Chinese have a secret vaccine that they used to protect their ruling class and military? Does the weather make a difference, because the worst-affected have all been areas with mean temperatures below 30 degree Celsius?
Do you get lasting immunity if you are infected? Do you return to full health if cured? There is a second wave of infection in Wuhan, and does that mean people can get infected again, and thus there is no chance of a vaccine? Are the antibodies in the blood plasma of recovered patients good enough as a prophylactic? Can these antibodies be manufactured separately so that there is a steady flow of them?
What percentage of those infected are likely to need emergency care? How many of them will need ventilators? So what’s the total number of ventilators we need to have per million residents? Can Ambu bags substitute for ventilators? Are makeshift 3D-printed ‘multiplexors’ that enable multiple patients to share a single ventilator acceptable?
These are hard questions, and we don’t have answers. Instead, Big Science has told us to—flatten the curve; wash your hands; don’t touch your eyes, nose or mouth; herd immunity is good (until it’s bad); wear masks (or not); and testing is good (or maybe it’s not so good).
Any reasonably well-trained monkey could have told us these things. This is not, let us be clear, carping about individual acts by heroism of doctors and nurses (let us remember Kerala nurse Lini Puthusseri and her poignant letter to her husband asking him to take care of their little boys, as she lay dying of the Nipah virus) but it’s about Big Science. Where is the vaccine? Where is the cure? Where are the protocols?
The behaviour of the World Health Organization (WHO) in the context of coronavirus has been startling, and gives the lie to the entire picture of rational, inexorable Western science. It is particularly galling to Indians because the WHO Chief Scientist is Sowmya Swaminathan, the daughter of famous agricultural scientist MS Swaminathan.
Yet, WHO showed almost no signs of being scientific, and every sign of being political, so much so that it has lost the trust of large numbers of ordinary people, doctors and policymakers. It showed itself to be a manipulable entity that endorsed theories convenient for the narrative that the Communist Party of China wants to propagate.
The most amazing was the confusion over masks. It stands to reason even to a layman that anybody wearing a mask would be a little more protected than one without, at the very least because you are aware, and will touch your face less often. But the WHO waffled, saying first that masks should only be worn by the sick and carers, and later reversing itself.
It’s not that masks are in such short supply, and anyway, makeshift cloth masks or handkerchiefs will do. Statistically, those countries where people habitually wear masks (for example, Japan, South Korea and other East Asian countries) correlate with much lower Covid-19 infection rates. True, correlation doesn’t mean causation, but why not be paranoid and use masks anyway?
Technology has been equally unproductive. What happened to all the champions of ‘move fast and break things’ and ‘disruptive innovation’? The general public has every reason to be even more disappointed with Silicon Valley than with the medical establishment, as it is an unmatched cluster of biomedical and technological capability. Think Genentech and antiviral maker Gilead Sciences, and all the Big Tech firms.
So where is the innovation? Where are the test kits? Where are the do-it-yourself ventilators, just as Stanford’s Manu Prakash came up with the Foldscope paper microscope or the Paperfuge centrifuge for malaria detection? Where are the clever new algorithms and apps to predict the spread of the disease so that people can protect themselves?
Or are the smart people in Silicon Valley not capable of anything more than dreaming up new ways of grabbing users’ attention and their personal data, to sell them advertisements?
Let us hope that the ‘techlash’ that has seen the public image of Big Tech suffering does not get worse with this episode. But is innovation no longer paramount in Silicon Valley?
Look at Google. It has a trove of medical data from Britain’s National Health Service, and it owns the fitness device maker Fitbit. Its Google X lab has a process for attacking the very large problems mankind faces. Yet, so far as I can tell, there has been no technology of value coming out of Google in the context of coronavirus.
Let’s look at another titan, Facebook. Its contribution: it donated 720,000 face masks it had stockpiled at the time of the California wildfires! That’s it?
Innovation is coming from elsewhere, in less dramatic ways: Indian Railways has converted 5,000 of its idle coaches into emergency mobile coronavirus beds, at sixteen to a coach, and these can be deployed anywhere within a day or two.
From Singapore and South Korea come apps that enable governments to strictly trace contacts and thus forecast, contain and deploy resources to the right place.
So, ‘Where the hell was Biggles when you needed him last Saturday?’ as cult classic Thick as a Brick from Jethro Tull asked in 1972. ‘And where were all the sportsmen who always pulled you through?’ What happened, Silicon Valley?
When ‘evidence-based’ science doesn’t have any answers, maybe tradition can help to a certain extent. This is because India must have faced hundreds of epidemics as a densely populated tropical country in its 5,000-plus years as a civilisation. The physicians who survived would have carefully observed what helped, arrived at a rudimentary understanding of germs, and codified safe practices in religious terms—preserve personal hygiene through washing hands, feet and face regularly; avoid touching other people, fold your hands in a Namaste; do not share food with other people or invite them into your kitchen; and, do not bring footwear into the house.
These are basic instructions, and nobody quite knows what is hidden in Ayurvedic practices for increasing general immunity and specific defences against similar viruses. Narinder Kumar Mehra, the head of the Indian Council of Medical Research (ICMR), wrote of ‘the definitive beneficial effects of Indian spices in augmenting immunity.’ Research may pay off handsomely, if not for this acute pandemic, but as prevention for future calamities.
Ironically, one of the outcomes of the pandemic may well be that the issue Big Tech has been most concerned about—data privacy—ends up becoming a casualty. The most successful defences against coronavirus have come from East Asian countries such as Singapore, Taiwan and South Korea which invasively used citizen data to control the spread of the disease.
Governments have got a taste for the kinds of uses it can put deep, detailed data to. It is hard to see how they will let go now. Even if they do not emulate the highly intrusive interference and control panopticon that China has built, many other governments will probably force Big Tech to part with the data about citizens that they have acquired with much effort.
Governments may invoke emergency powers to force Big Tech to divulge location and other information about citizens. Apple had earlier refused to reveal location data and had gone to court to prevent the US Federal Bureau of Investigation (FBI) from accessing it. Facebook subsidiary WhatsApp has pleaded that it cannot break the encryption it uses in messaging.
India’s fledgling Data Privacy Act, now in draft form, allows governments to declare its agencies immune to privacy protection, presumably on national security grounds. Ironically, the pandemic may render Big Tech vulnerable to sovereign seizure of their most valuable asset—data.
Things definitely look bleak at the moment; however, Big Science and Big Tech are beavering away, and it may be only a matter of months that a vaccine is invented, or a totally unexpected disruptive innovation turns the table on the virus. Then they can be heroes again, and we can once again sing our hosannas and hallelujahs to them. But so far, they have failed us badly.