Michael Friedman interviewed by Bill Resnick
Posted April 24, 2020
Let’s start with the origins of this pandemic. Where did Covid-19 come from?
For the past few decades now, there’s been an uptick in these emerging diseases, which are products of capitalism’s disruption of the relationship between humans and earth’s ecosystems. There have always been transfers of diseases from animals to humans and probably back the other way too, for example, rabies or the bubonic plague. But, in the past three or four decades, this has increased sharply. Deforestation and the decline of biodiversity have facilitated the threat of these diseases. And we’re talking about diseases from HIV to Lyme disease, to Ebola, to Zika to Hantavirus, and the Coronavirus.
Where did Covid-19 come from?
What are the challenges to ending the global pandemic?
How should the left respond?
A well-known area of ecology called Biodiversity and Ecosystem Functions and Services began developing about 20 years ago. It studies how biodiversity contributes to various functions that shape an ecosystem. We’re talking about things like carbon storage or net productivity. We’re talking about things like resilience, the ability to bounce back. And we’re talking about things like resistance to invasion by pests and pathogens.
Diseases will spread through an ecological community much more easily when biodiversity has been reduced. Biodiversity is being reduced on our planet. We’re faced with habitat destruction, deforestation, contamination of habitats and so on. Many, many species or populations of these species are disappearing.
Biodiversity and the dilution effect
A robust ecosystem includes predators and competitors of animals that are normal hosts for a lot of viruses and bacteria, so there are fewer primary hosts for the pathogen. Diminishing biodiversity then expands the number of potential hosts. Second of all, in diminishing biodiversity you are eliminating alternative, poorer quality, hosts for a lot of pathogens. This is what they call the dilution effect. For example, in the natural environment, Lyme disease affects more than just deer and mice. It affects squirrels; it affects other organisms. But these other organisms are not necessarily the best hosts to the bug. The bug hasn’t adapted as efficiently to these hosts, and so it may not be able to reproduce in them or it may not be able to make the connection with vectors like ticks and so on.
These are some of the ways that biodiversity decline actually enhances the possibility of transmission of these bugs. This is what has happened in the case of Lyme, in the case of Hanta or, perhaps, in the case, which I’ll explain, of Covid-19.
Organisms that survive biodiversity decline are often opportunistic species. They’re often what we would call generalists, like bats or rats or mice. These organisms proliferate in areas where biodiversity has been reduced, where there’s been deforestation, where human settlements are creating edge environments. So, for example, the deer mice that carry Lyme proliferated in grassy fields in the suburbs that were created when real estate development took place. Hantavirus is a rodent-borne virus in the Southwestern United States and it began proliferating with increased agribusiness and irrigation along with suburbanization and urbanization.
In the case of Ebola, bats proliferated in West Africa where oil palm plantations were put in and replaced forest. So, now you have greater contact between humans and the primary host as well.
When I lived in Nicaragua, a big problem was that the landowners would push the poor campesinos, the poor farmers, off their land and then they would migrate further into the forest and slash and burn the forest and what we know now is that these type of activities expose people to the risk of contracting various pathogens from organisms that are being pushed into smaller and smaller spaces and with reduced diversity.
We also have to take into account the effects of climate change. For example, the vectors and hosts of the Lyme Disease bacteria are spreading out across the Northern US, now showing up in Michigan and further west
The Origin of the Coronavirus in China
So, in the case of Covid-19, Hubei Province, where Wuhan is located, has been the most rapidly industrializing area in China for the past century with a very high rate of deforestation. And you have an affected pool of animals, of horseshoe bats, which have been carrying the virus for a long time. The virus has adapted to enter into bat cells and the bats’ immune system has evolved to deal with it. Over time a pathogen often will co-adapt with a host under natural selection, so it doesn’t kill the host, because it’s kind of disadvantageous under most circumstances for the pathogen to be automatically fatal.
But, when it transfers to other mammals, there is the potential for it to become deadly, to become virulent.
There are two theories about how bats transferred the virus to people. One is that it transferred from an isolated population of bats (and I should point out that bats have not been properly sampled, so we don’t have samples from all populations of horseshoe bats.) The other theory is that the virus made the transfer to humans earlier, but it hadn’t mutated to its virulent form, so it wasn’t detected. And this could have happened months ago.
And there’s also a possibility that another mammal, possibly the pangolin, picked up the virus en route, and became an intermediary for transfer to humans. Now, one way this could have worked out is through wet markets like in Wuhan, where there are cages of animals, like pangolins, stacked one on top of the other, live animals. So, basically, you have animals on the top layer defecating and urinating and sneezing and coughing or whatever and infecting the animals below them. And you’re talking about animals that are never in contact with each other in the natural environment.
And then you have people who are managing the animals. We’re not talking about eating bats. We’re talking about being in proximity with animals in the presence of a virus which is transmitted readily by aerosol, by droplets sneezed out or coughed out or in the process of talking, in humans.
Is this virus so much more dangerous than the common flu virus?
First of all, we don’t know very much about it. Other coronaviruses have been studied, but not extensively. The common cold is a coronavirus, but it is not very threatening and research on it not profitable. SARS and MERSA, two other coronaviruses, were deadly and there had been some research on them. But, these viruses were controlled fairly quickly, so there was less urgency about studying them.
With the present coronavirus, you have a relatively unknown pathogen with what appears to be a significant mortality rate and a high rate of transmission. At this point, we don’t have the information we would need to judge how it compares to the common flu. And everything we do know has to be treated as tentative.
Given that caution, how dangerous and infectious is Covid-19?
The global average death rate, based on confirmed cases and confirmed deaths, according to the WHO, was 3.4%, as of March 3. But this figure is rather meaningless, first off, given the lack of adequate testing on a global level and the efforts of various authorities to cover up the scale of the disease in their countries. I mean, the number of deaths has been seen to be vastly under-counted. Same with the number of confirmed cases. Some 20-30% of cases are thought to be asymptomatic. Many more are mild or not severe enough to require hospitalization, and so may go uncounted.
Mortality rates, transmission rates and prevalence are also functions of social inequality and poverty, so death rates vary greatly from that global average for marginalized and oppressed populations, as we’ve seen in New York, Chicago and elsewhere. Oppressed communities also have less access to testing and authorities in many places are not even reporting demographic data for the disease.
As we know, the mortality rate varies across age groups. An early estimate by the WHO in China was that the death rate for those over 60 was 3.4% and the percent steadily rose with age so that the death rate for those over 80 was 15%. That was before the Chinese authorities recently increased the number of Wuhan confirmed deaths by 50%. In New York City, 95% of deaths were among those over 44 years old. Almost half were among those over 75. So, the real mortality rate is going to vary from that global average according to the age structure of the population of a given country, as we saw in Italy’s case, where an aging population succumbed to coronavirus at a much higher rate.
Moreover, we may have seriously underestimated the pathological manifestions of Covid-19, leading to an undercount of deaths: it turns out that the coronavirus doesn’t just kill by attacking the lungs, but also presents significant cardiac, renal, neurological and other pathologies, either directly attacking these organs or by triggering a hyperimmune response. A recent Science article noted that deaths due to heart failure, renal failure and disruptions of other organs and systems were initially misdiagnosed, but later turned out to be related to Covid-19.
Covid-19 also appears to be highly transmissible. On average, according to some estimates, each person will transmit to 3.5 other individuals (its reproductive number, R0=3.5). So, you’re talking about an exponential increase in infected people. But, again, transmission rates are determined by factors beyond the innate, biological propensity of the virus, such as crowding, use of PPE, social distancing, etc.
At this point, social isolation—diluting the human hosts for the virus—is our only defense against the disease. But pressure is building to end social isolation, as the curve of infection begins to flatten.
The curve is apparently flattening in New York, although keep in mind that case numbers and mortality numbers are extremely unreliable, even in New York City and State.
But, New York City and State are NOT the U.S., which is a very large and heterogeneous place: geographically, demographically, economically. So, while case and mortality numbers may be flattening out in New York, they are increasing in urban and rural areas in many other states. There are many areas in the U.S., with large, dense, impoverished, indigent populations and poor or nonexistent public health and medical infrastructure, in which control of the virus is going to be difficult, if, in fact, there is a will to do so.
Even if Covid-19 is brought under control in the US, will it spike again once social distancing ends?
This is an extremely complex issue. Researchers are waiting with bated breath to see what happens in China. That country seemed to have reduced their reproduction number to below 1, which means that each case will infect fewer than one other person. However, some countries that brought the virus under control, such as Singapore, are spiking again.
One issue is whether individuals and the population can develop immunity, through exposure to the virus. The verdict is still out on the question of natural immunity. A large study in Wuhan showed that while some people developed antibodies following infection, others did not. One positive aspect is that older people seem to develop antibodies more readily than younger people. On the other hand, development of antibodies does not necessarily mean that we have immunity.
An earlier study pointed out that the antibodies we generate must bind to the spike protein that permits viral entry into cells in order to neutralize the virus. In that study, a significant portion of those antibodies bound to other viral proteins and failed to neutralize the virus. And this virus is tricky (although not as bad as HIV): it covers itself with a “camouflage” of sugar molecules to trick the immune system. What is more, for some viruses, we retain an immunological memory for a lifetime, while for others, our immune systems retain a memory for a short time, and this isn’t only due to the viral mutation rate, but to the virulence of the pathogen, and other factors.
What about developing an effective vaccine?
This depends in part on the virus’ mutation rate. HIV and the flu mutate quickly (meaning the surface proteins are altered), leaving our immune systems eating dust. In the former case, the mutation rate is so high (together with extra-viral “camouflage,” noted above) that it has forestalled development of vaccines. In the latter, we devise vaccines on a yearly basis to try to keep up.
Although Covid-19 appeared at first to be fairly stable, researchers recently discovered that the virus has mutated into two strains, one much more virulent than the other. The virulent strain is the one that has impacted Europe, and then spread to New York, while the less virulent strain affected Asia and then made it to Washington state.
There appears to be consensus among public health experts that without a vaccine, adequate testing and quarantine of infected individuals is necessary to lift social isolation without creating another spike in infections that could overwhelm the healthcare system not to mention causing many unnecessary deaths. What are the challenges facing us here?
The U.S. has opted for a mitigation strategy, principally involving social isolation measures, personal hygiene, and, subsequently some travel and crowd restrictions and closures of worksites and schools, measures which started late and have varied in extent and timing across states. Yet, virtually every country that has managed to bring Covid-19 under control has employed a viral suppression approach. Suppression means rapidly reducing the Reproductive Number to less than one, and keeping it there. Suppression measures include the previous, or more vigorous, social distancing measures, but also curfews, restrictions of movement outside the home, rigorous quarantines of cases and contacts, up to a total lockdown. Extensive and timely testing was the key to the success of these suppression measures.
Accurate measures of numbers of cases and of mortality is necessary both to track and quarantine cases and their contacts, and to conduct random community sampling, in order to identify hot-spots. It is necessary to evaluate whether social distancing is working and to know when to ease it. It is also necessary to calculate the death rate. Testing has been woefully inadequate in the U.S. By the end of the first week in April, the average seems to oscillate around 150,000 tests per day. The most current figure for tests per thousand people for the U.S. is about 12, which places it at number six in the world. Iceland still has the most rigorous testing in the world.
There are other problems with the tests that need to be overcome. One, of course, is the overly strict criteria for testing, which is largely limited to hospital patients already showing symptoms of severe infection, along with medical personnel (and those with the money or clout to circumvent the restrictions). To be effective, testing would hopefully be applied to identify all suspected cases (anyone who walks into a doctors’ office, as one expert put it) AND sample enough asymptomatic cases to allow for an estimate of their prevalence. For another, at this point, many clinics and labs are running out of supplies, in large part due to lean production of these materials and outsourced, international supply chains. A third is the two-three day turnaround time between swabbing the patient, running the PCR, and getting the results back: a delay that costs lives. For a fourth, this test has a high rate of false negatives: it misses up to 20% of cases for a number of reasons not necessarily related to the test itself.
One option is to use antibody tests, which can be done with a pin-prick in a few minutes. These will allow doctors to determine if a person has been infected at some point. In turn, this will allow a better estimate of prevalence in both symptomatic and asymptomatic individuals, and a possible assessment of immunity. There are caveats: that such a test won’t pick up antibodies early in the infection, that not everybody seems to develop antibodies, and that not all antibodies confer immunity.
Are there other challenges to ending the global pandemic?
Whatever technical measures are used will inevitably run up against the wall of existing social inequality. Social isolation and lock-downs are not applied on an even playing field any more than the disease itself is “equal opportunity.” To varying degrees, much of the world’s population has been subjected to four decades of declining living conditions or absolute impoverishment as a result of neoliberal austerity and “one-sided class warfare,” on top of the historic dispossession of masses of people in the global south and the inequities of racism in the global north.
Leaving aside the co-morbidities produced by these oppressive relationships, measures such as social isolation, home quarantines, curfews, contact tracing and even personal hygiene, will have radically different meanings for and impacts on homeless people, families living crammed into in crowded apartments or ramshackle dwellings and densely populated slums, working class families living paycheck to paycheck, people lacking access to clean running water or basic sanitation or adequate food sources. Domicile quarantine is meaningless if you are homeless and can be a death sentence if you can’t get food. It is no surprise that food riots broke out in impoverished parts of southern Italy after that country imposed its draconian lock-down. But, these social conditions also mean that such measures may be ineffective, leading, again, to a resurgence.
Given what you’ve said about the causes of this pandemic, how do you think the left should respond?
I think this provides another argument for an expanded Green New Deal. We need a program that’s going to address these environmental issues, while providing economic security, food security, housing security, you know, basic needs for people, and we need to amplify the Green New Deal to incorporate Medicare for all, universal healthcare, I would say, because both of these are necessary in the short and in the long run to, to prevent and stop these pandemics from taking the toll they do.
Additionally, we need to protect ecosystems and prevent biodiversity decline and that involves things like agroecological production. It also involves ensuring that people have enough food to eat and aren’t constantly being forced off the land to move further into forests bringing them into contact with immunocompromised animals that are being affected by biodiversity decline.
Yes, it seems to me that if the West wants to save itself, it needs to meet demands by the global south for technology transfer and resources.
Absolutely. The global south has been subject to what we call ecological unequal exchange for – – for decades, if not centuries, whereby the wealth of these countries flows up north and then the ecological and environmental catastrophes are exported to the south. So, there’s definitely a need for environmental reparations, but this should not let local oligarchs off the hook either, because there is also a huge need for social transformation, including agrarian reform.
Mike Friedman is an evolutionary biologist teaching at the University of Antigua Barbuda in the Caribbean. For the last several years, he’s been studying and writing on the development of dangerous viruses around the planet, including Covid-19. In addition to his scientific writing, he has published several articles in Monthly Review.
Bill Resnick co-founded the Old Mole Variety Hour on KBOO, 90.7fm, Portland, OR. He has written for Socialist Review and Against the Current among others. He also wrote for, edited, and chaired the editorial collective of the Portland Alliance, for 30 years the voice of radical Portland. This article originated in interviews on KBOO radio, 90.7fm, Portland Or.
The transcript was edited by Johanna Brenner.