If we could but look at our lovely planet earth from afar we’d see that iconic blue marble. If we could look more closely, we could see that it is blanketed in lots of microbes; a veritable robe of virus covers her lovely blue roundness.
And if we could see hot spots, places where the virus break out of their usual routine lives of happily reproducing in their weirdly parasitic way, we could see the places that Mother Earth is calling our attention to.
I’m a medical anthropologist, I look for patterns both cultural and biological. I see layers and layers of environmental affronts to the earth, of air pollution so bad it is the cause of millions of deaths each year and I see overlaying that pollution, heavy smoking patterns, exceptionally high for men in China and I see lungs that are susceptible to viral infections. Lungs so damaged by years of inhaling filthy air and cigarette smoke that they no longer can mount an effective immune response; they can no longer clean out the garbage from their distal spaces. These lungs will drown once hit with the coronavirus.
This situation is a good example of what the medical historian Mirko Grmek called pathocenosis.
“By pathocenosis, I mean the qualitatively and quantitatively defined group of pathological states present in a given population at a given time. The frequency and the distribution of each disease depend not only on endogenous—infectivity, virulence, route of infection, vector—and ecological factors—climate, urbanization, promiscuity—but also on frequency and distribution of all the other diseases within the same population” (Grmek, 1969).
As Gonzalez et al continue, in their recent application of this concept, “Thus, for the first time in the history of medicine—beyond a nosological framework that encloses diseases in a frozen disciplinary framework (e.g., respiratory diseases, arboviral diseases, sexually transmitted diseases)—Grmek offered a temporal and spatial approach to understand the dynamics of infectious diseases and their interdependency.” Ecohealth. 2010 Jun; 7(2): 237–241.
Published online 2010 Jul 1. doi: 10.1007/s10393-010-0326-x
Viral spread is largely about density of people— Asia has the highest density in the world, then Africa (perhaps, the coming storm) and then Europe. Asia and Europe are the hardest hit now, we will see how it will move forward. The African continent is located between Asia and Europe, it is linked economically and socially and I would think it is only a matter of time before the Covid-19 makes an appearance there.
Oh, and then there are the cruise ships. Talk about population density!
Weaknesses show up at many levels. The weaknesses of the institutionalized elderly in the US, (density) and yes, ‘underlying causes’ –weakened immune systems, chronic illnesses and immobility, oh and not so very much social distance at all.
And not just the elderly, it is the institutions themselves that are weak, nursing homes and hospitals with only the bare necessities and only minimal staffing. In the event of an increase of 10% in the in-patient load many would collapse for lack of staff, lack of supplies, lack of equipment, lack of planning and resources. This article on biosecurity and what hospitals would need to do to effectively respond to an outbreak is from John’s Hopkins; it is very informative.
What is it that our earth is trying to tell us? If we could see the places on the blue marble most affected, if they lit up brightly, what could we learn? We are in a syndemic, not just of coronavirus, but of multiple levels of pathological states and behaviors.
This virus will surge and it will wane, we will wash our hands, and we will need to be better prepared next time.
Elizabeth Cartwright, RN PhD, is a medical and visual anthropologist who works in Latin America–mostly. Her work is focuses on environmental health, social justice and anthropology with an applied focus; she is a professor at Idaho State University in the lovely Rocky Mountains.