Science

Why It Took Us So Long to Understand the Coronavirus

And what we now have to prepare for.

Tedros Adhanom Ghebreyesus in front of a World Health Organization–branded backdrop.
World Health Organization Director-General Tedros Adhanom Ghebreyesus speaks during a press conference on Jan. 30 in Geneva. Fabrice Coffrini/AFP via Getty Images

Six months into the pandemic, what have we learned? For one, a lot about the coronavirus itself, from how it transmits to the best way to shield oneself against it. But it took us many, many tragedies before we got here, and there’s so much we wish we could have known earlier. The problem is COVID-19 required an urgent response, but science tends to move slowly and carefully. And once certain beliefs get cemented in place, it can be hard to change them. So for Wednesday’s episode of What Next, I spoke with Apoorva Mandavilli, a science writer over at the New York Times, to recount what we’ve learned about COVID, what we really should have known sooner, and why we didn’t know it then. Our conversation has been edited and condensed for clarity.

Mary Harris: You did a deep dive into the debate over whether the virus is airborne. I wonder if we can talk about it in depth, because it was really interesting to look at your reporting and think about all the reasons why we seemed to miss this possibility in the beginning. Some people still seem to be missing it. How did you first get interested in the idea of why the virus being airborne was something people weren’t picking up on or talking about as much?

Apoorva Mandavilli: One of my colleagues and dear friends, Roxanne Khamsi, actually first broke the story in Wired. She wrote about how among aerosol scientists, there was a pretty clear sense that this virus is, in fact, airborne, but there was a lot of resistance to the idea. So she dug a lot more into the historic studies that show how this has been true for the flu and other viruses.

I remember her article because it came with this graphic of two people talking at each other and you could see the bubbles of particles and air intermixing in front of them. And you realized how the virus could be suspended and exchanged pretty easily.

It makes sense, right? That was really the first inkling that there wasn’t enough conversation about this. I started asking people whenever I was interviewing them for other stories about where they stood on this and what they thought about the evidence. And I started to hear that it was pretty firmly divided into two camps: people who understand how aerobiology works and how viruses move through the air, and people who are from this mindset of droplets and coughing and sneezing and surfaces being the main source of transmission.

The conversation kept coming back to the World Health Organization being the driving force of resistance to the idea. So I concentrated all my focus on that because WHO is hugely influential and it’s been front and center in this epidemic. It had daily briefings at the time, and everything it said was being reported widely. As these stories often end up, it’s about a few opinionated people who really hold up the progress. I ended up hearing that in the internal committee meetings, there were a few people who really, really believed in hand-washing, and in the idea that bigger droplets from coughing and sneezing are the only way somebody can get sick, and that aerosols, which can travel farther and stay in the air, don’t really matter. It seemed like the conversation stopped there.

I think what’s happening is some of those people really want to see a lot of evidence before they change course. They take the science-moves-slowly thing very seriously. They want to see a full randomized clinical trial—which is the best way you can do a clinical trial with all of the evidence being irrefutable—and then change their mind. So they were just setting the bar for when science will correct things a little too high.

For a long time, WHO really was against people wearing masks. Also for a long time, it had a real reticence to talk about asymptomatic spread. So when you look at that, I wonder if you think it’s a WHO problem or more of a scientific problem.

It’s a little bit of both. It’s the kind of scientific expertise that WHO specializes in: certain kinds of scientists who are cautious and slow to move. I think, in this pandemic, that has not served them well. I don’t want to take away from all the great work they have done, but you’re right that they were a little hard to understand on the masks issue and on asymptomatic transmission.

I don’t have conclusive proof of any of this, but this is what I’ve heard: The masks issue came back to this idea of hand-washing. There were people who thought, if you tell people to both wear a mask and wash your hands, they won’t be able to prioritize both. Also, I think they were worried about the availability of masks. They think about all of these low- and middle-income countries all over Africa and Latin America and Asia, and they did not want to have a run on supplies of that kind.

People are trying to act fast to avoid a disaster, and they’re looking to scientists. Then, the scientists move slowly. But that’s kind of their whole thing: Don’t get out in front of the data.

It’s a completely natural conflict. But I think we have to find out how to resolve it because this isn’t going to be our last pandemic. When the dust settles, we may really need to think hard as a society about how we process this kind of information and make decisions quickly.

On the mask issue, for example, the idea that you wouldn’t recommend them because the evidence for them isn’t very strong just doesn’t make a lot of sense. Masks are inexpensive. They’re easy to produce and wear. And even if it just reduces the risk, it’s worth doing.

Overall, we also really needed to have been thinking about the bigger picture, not just bars and restaurants and shopping malls and motorcycle rallies, but prioritizing schools. Who do you hold accountable for that?

I think governments at every level. One of the only examples I’ve seen of that kind of thinking came from Seattle, where they did a modeling study and estimated that their activity in the community—shopping, going to church, all of those things—would need to be at about 70 percent of the pre-pandemic levels in order to do other things. This ideal of a risk budget, if you will, where you take X amount of money or risk in this case from one pile and put it into the other. So if schools have this much percent, we should be bringing that down. Risk budgets will probably look different for each community or school district. But I think they could use a lot of help from state governments and from the federal government to have access to the right experts and to at least get some top-level priorities that they’re working with.

A few months ago, we did a show about our pandemic summer and how it was going to be so strange. But I wonder if, now that we’re in the heat of summer, people like you are thinking about our pandemic winter, what that will look like, and whether we know if there’s a way to control that at all now.

It’s a really good question, and a really sad and scary one. I don’t think we’ve learned the lessons we needed to learn to face the coming seasons with any feeling of security. I think we’ve squandered a lot of time in getting ready and keeping things under control.

Having said all that, though, I do think it’s also important for us to give ourselves a mental and physical break. When things are nice outside in summer, when it’s possible to be outdoors. I have been telling friends and family to get outside and enjoy it as much as they can, to have physically distanced social gatherings in parks or wherever, because come fall and come winter, it’s going to be like the spring again, where we may have to spend weeks at a time without seeing other people.

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