09/06/2020

Science and epidemics

With the rise of modern science came the attempt to analyze, understand, study and -if possible- neutralize the effects of infectious diseases and epidemics with analyses that contemplated the state of science at the time and, in many cases, as  incentives for the advancement of science itself; while simultaneously leaving aside mythical and religious explanations.

Note that the study of infectious diseases and epidemics is not exactly the same, and the approaches through which knowledge has been acquired regarding one or the other are different, though obviously closely related: the great English physician Edward Jenner developed the vaccine against smallpox and put it into use in 1796, which not only saved individually millions of vaccinated people, but led smallpox to be considered completely eradicated after many years of worldwide compulsory vaccination.  But was it forever? The epidemics of many other diseases have also been minimized or practically eradicated thanks to vaccines (unless, of course, the irrational anti-vaccine movements succeed in convincing enough susceptible folks so that some of these other diseases go back to posing a public danger).

Perhaps the origins of epidemic research can be traced back to the work of Dr. John Snow, a 19th century English physician and hygienist who was able to trace the origin of a cholera epidemic in London in 1854 to a public water pump using a non-medical or biological approach as was traditional but an “epidemiological” one (however rudimentary it may have been):  he talked to neighbors, and used a map of the city to mark the cases. Primitively, given the knowledge of the time, he also applied Statistics to the analysis of the data available; the truth is that Statistics is a discipline of great importance in epidemiological studies at present.

It is therefore possible to see that Jenner and Snow's approaches, both brilliant of course, were completely different, despite them both being doctors: Jenner devised a vaccine, Snow tried to control the contagion. Of course, both approaches complement each other, as we currently observe in a world anxiously waiting for a coronavirus vaccine, while a good part of the pandemic strategy consists in trying to avoid infections. It seems ironic that the principal mechanism adopted by most nations is quarantine, which has been in use since before the beginning of modern science, showing us how helpless we remain in the face of this totally unexpected situation.

But the treatment of an epidemic –and especially a pandemic- involves not only doctors, biologists and, in general, representatives from the natural and biomedical sciences, but also specialists in mathematics, statistics, computer science, data science and similar areas. In addition to these disciplines, which are close to the natural sciences, the social sciences and humanities also begin to have an important relevance: we see clearly today that the opinion of sociologists is important in the analysis of how a society reacts to quarantine; that psychologists assess the effect on individuals of these confinement situations; that historians know –which allows them to foresee- the behavior of populations and their rulers in past pandemics; that economists can estimate economic collapses, alleviate them and prepare each country for its post-pandemic recovery; and, of course, that political scientists, can  help ensure that the inevitable social tensions can be reasonably handled.

Nevertheless, it is not my intent to describe an ideal situation where the governments of all nations receive interdisciplinary support from scientists in the areas mentioned. Nevertheless, the shocking mortality figures associated to the coronavirus indicate the high cost incurred by some governments that have not paid attention to their scientists. All modern science is increasingly interdisciplinary, and in the face of a pandemic like the one we are having to live through, interdisciplinary action, as broad and collaborative as possible, is almost a question of life or death,  especially considering the remarkable degree of ongoing uncertainty and the possibilities of scientific errors due precisely to this uncertainty as well as to the existing pressure to obtain results.

However, in this critical situation, other factors are also present, which should not be neglected. An important factor is that, despite the fact that scientists from different countries are collaborating with each other in many ways, there is a perceived latent competition between companies and between nations, to see which pharmaceutical company (and from which country) comes first in the race for the greatly desired coronavirus vaccine. Of course, the sooner a vaccine is available, the better, but let us not forget the huge economic interests that lie behind that goal (and, although companies in particular may sacrifice short-term profits by showing their generosity in distributing the vaccine - which is yet to be seen-, in the long run, the benefits and the prestige obtained for having crossed the finish line first will be greatly compensated). In this sense, an important antecedent to consider is what happened with the polio vaccine: Dr. Jonas Salk was generous enough not patent it. Will the same happen now?

Finally, let us mention another significant factor: the confrontation between the two greatest powers of today, the United States and China, not only did not diminish despite the need for joint action, but has worsened to a level unseen since the end of the Cold War. Although it is risky to formulate precise forecasts regarding the immediate future, it is clear that science, in its various disciplines, will be subjected to tremendous pressures in a much more explicit and overt way than these pressures have been manifested before.

Pablo M. Jacovkis is the Secretary of Research and Development at the National University of Tres de Febrero.