Anirban Mahapatra on why the world needs a 'one-health approach'
In his new book, the microbiologist talks about the covid-19 'infodemic' and why we will see the emergence of more viruses
At the beginning of his new book COVID-19: Separating Fact From Fiction, Anirban Mahapatra, assistant director and publisher at the American Chemical Society, astutely encapsulates the current notions about covid-19. A pandemic, he writes, is like an elephant described by nearly eight billion blind people, each grasping at one or a few parts and trying to make sense of the whole.
The description is based on the well-known parable of six blind men who touch an elephant and reach a variety of conclusions. This is exactly where the current pandemic stands. There’s an ocean of information on covid-19. Only some of it is accurate. “A lot of it is fictitious,” says Mahapatra on a Zoom call from the US. “Through Twitter, I started to dispel some of these rumours but that’s an ongoing process.”
For instance, the phrase “flattening the curve” has become common parlance over the last year or so, but, as Mahapatra writes, it has its roots in an influenza preparedness plan devised by the US Centres for Disease Control and Prevention (CDC) in 2007. He was keen to demystify such terms: “I really wanted to write a book that was simple.”
Mahapatra took inspiration from the likes of The New York Times science writer Carl Zimmer, who he greatly admires, and renowned Harvard University chemist George M. Whitesides, who has written over 1,100 research articles. “Whitesides’ approach is to consider writing as part of the research process, beginning with an early outline,” says Mahapatra. “Each draft gets reviewed and rewritten at least 15 times. He advises against writing after all the data has been collected and the project is complete, because that day may never come.” In an interview, Mahapatra spoke about tackling the “infodemic” around covid-19 and the rare positive takeaways from it. Edited excerpts:
At what point did you decide to write a book on covid-19?
When the novel coronavirus reports were coming out of Wuhan, China (last January), and they had started to build huge hospitals in these massive fields, at that point India was very much concerned with what was going on in Delhi. In the US, there was discussion on (Donald) Trump’s impeachment. Nobody had any idea it was going to get this massive. Towards the end of January, when the reports began to come out, I started following it carefully.
I hadn’t decided to write a book at that point. I think when the lockdowns started globally in March, it also became apparent to me that we needed to go beyond science. This was not just a scientific or medical pandemic, this was also a social pandemic. At that point, I thought I need to document this and start to write about it in a way that I can remember and relate all the information about this pandemic to other people. Now, the flip side is that there has been a lot of information about this on a daily basis. That’s what is in the title: “separating fact from fiction”.
What was the idea behind breaking down the chapters into simple pointers like “Emergence”, “Spread” and “Vaccine”?
When I sent in the proposal (for the book), it was not shaped that way. It was going to be a comparison of covid-19 with other pandemics. Along the way, I was getting questions on Twitter. I used that and my communication with other people as a test case to figure out what people were interested in and what their queries were. I wanted to write something that was comprehensive and encyclopaedic. So that’s why the chapters are like that.
To write about the pandemic, you surveyed the science of coronaviruses. How challenging was it to condense all that information?
That is one of the hardest parts. I went back even into the 1990s, when corona virology was considered the backwaters of virology. Before SARS, there weren’t that many people in the world who were interested in coronaviruses. Last year, the sheer number of (scientific) papers, at one point, was doubling every two weeks. So distilling that on a daily basis was probably the most challenging thing. Other challenges included keeping on top of the literature that was published every day and making sure that everything that I was putting in the book was absolutely up to date and had the backing of the most current and agreed-upon science.
Bill Gates described covid-19 as the first modern pandemic. You have drawn parallels between covid-19 and past outbreaks. What made this current outbreak so devastating?
In 1918, nobody knew what a virus was. Everything that we found out later was based on case counts and excess deaths. Now, we obviously have many diagnostic tests, like the RT-PCR. We have a better sense of what’s happening. But as I write, there are aspects of our society now that are going to precipitate the emergence of more pandemics and viruses. We are seeing two or three new viruses emerge every year and most of them are RNA viruses, like influenza and SARS-CoV-2.
Some of the precipitating factors are global travel, which did not exist at such a scale in 1918 as it does now. If you look at the 1918 pandemic, it came to Bombay (now Mumbai) and then spread out via travel routes. We noticed this even with SARS.... In January-February (last year), when the travel bans were implemented, it was a good idea but it was already too late. The disease had already been spread.
There are some positive aspects as well. Look at how from January through March (last year), the entire world changed. A lot of it was devastating but people in many countries started wearing masks, learnt about social distancing. It was also the first pandemic of the social media era, where you could move online and see the number of case counts. Nobody had ever thought (the phrase) about flattening the curve as something that you did or where every person could collectively participate.
Do you feel there will be more public interest in infectious diseases and medicine in the future?
I was happy to see in India’s budget that there is more funding for (the healthcare sector and vaccine development), that in the US, there is also a renewed emphasis on funding the CDC and putting together pandemic preparedness plans. The unfortunate part is that the US actually had plans to prepare for a pandemic, but they were never implemented. So it’s good to see those being implemented at last.
Early on in India, there was a lot of concern about testing. That changed later on during the pandemic. I am heartened to see now that from a scientific perspective, there is more focus on building up these infrastructural units and providing more research funding. I was very happy to see scientists come together and come up with a vaccine and certain drugs in under a year. We need more people interested in science, working on diseases of the future that haven’t emerged or made that spillover jump from animals yet. The other thing we need is what is called a “one-health approach”, in which we consider animals, the environment and ourselves as part of one combined ecosystem.
The flip side is that if you look at 1918 and subsequent pandemics, people are also eager to move on and forget about what they did. What will be the long-term impact of this pandemic? There will be some on cities and on work from home. I don’t think much will change for people in the emergency sectors.
Are there any positive takeaways from the manner in which we are dealing with covid-19?
When I was starting my career, I dealt with the H1N1 pandemic which nobody actually paid much attention to. It was not a very deadly pandemic. Maybe initially people thought covid-19, too, was not going to be that serious.
The vaccines are one positive. But now everyone has an opinion about the lockdowns and whether they were necessary or successful, not just in India, but in other countries. We have to look at it from the sort of the fog-of-war perspective of early March, when we didn’t know much about the virus, how deadly it was, how it was going to spread, whether some people had immunity or not. The fact that all of these countries could make decisions based on science and get minimum pushback from citizens, I think, is a major positive. We went from a position of no masking to universal masking. I think that is going to continue even after the pandemic.
Then, companies being able to pivot, when they could, to the work from home environment. Had this pandemic happened 10 years ago when there was no Zoom, when there were not many technologies we could have used, it would have been a very different pandemic from the perspective of our lives and economy.
You have written the cost of this pandemic will be enormous. In terms of society and the economy, how do you see the world being reshaped?
If you look at the Western world, it has not been taking infectious diseases as seriously as people in the so-called global south. I grew up, and you are, in a place where we always have to worry about what water we are drinking, does it look clean? We have to worry about mosquitoes and malaria, etc. But when you are in a Western country, the way it is set up, and because of the advances it has made, they had started to forget about infectious diseases. Because of that, I think they probably downplayed it and were not prepared for it, much more than, say, countries like South Korea, Japan, Hong Kong, or even China. These countries were hit early and very hard but the approaches they took were far more effective than a number of the Western countries, who were delayed in their responses.
I believe there will be a rethinking of this once the pandemic is over. Just the sheer number of deaths in the US is devastating. The other thing is, we saw scientists moving forward, but some of the countries you would have looked to for leadership were not there. The US, for instance, which is often looked to as the leader, definitely fell behind. So we could see a reshaping of the world order.... I do think there is a global shaping and reordering happening. India’s economy took a massive hit last year like many others, but I am confident that we will bounce back pretty soon.
'COVID-19: Separating Fact From Fiction' releases on 22 February; Penguin Random House India, 256 pages, ₹599.