Immunity, Interdependence, and the Shared Root of Our Safety and Our Sanity: Eula Biss on the Science and Social Dynamics of Health as Communal Trust

Social and biological, our interdependence is a defining feature not just of our civilization, not just of our species and all living types, but of life itself– life the physiological procedure and life the psychosocial phenomenon. The development of cell theory was reinventing biology, making of this philosophical field as old as Aristotle an even more recent science that illuminated the essence of life. Biology ushered in the discovery that every cell belonging to me as excellent– as healthy, as essential, as fit for duplication– belongs to you.

That delicate interdependence of life and lives, with its tangled roots in biology and cultural history, is what Eula Biss checks out in On Immunity: An Inoculation (public library)– a book of penetrating and poetic insight, drawn with that rare scholarship capable of fixing the distorted cultural hindsight we call history; a book of incredible foresight, conceived in the wake of the H1N1 flu pandemic, yet speaking with astonishing prescience to the complex epidemiological realities and social characteristics of the COVID-19 pandemic unfolding more than 5 years after its publication.

When Robert Hooke looked at a piece of cork through an early handmade leather-and-gold microscope in 1665, he named the unusual irregular “pores” of its honeycomb-like tissue structure cells, after the little nearby areas in which monks invest their voluntary holding cell. It would take another two centuries for researchers to find that cells are the standard biological units of life, that they remain in continuous osmotic communication with one another, and that they reproduce themselves to become new cells, each a whispered word from the language in which life talks to the future.

Months after Rachel Carsons Silent Spring awakened mankind to the delicate connection of nature, Dr. King awakened humanity to our fragile dependence on each other.

For Biss– the daughter of a medical researcher and a poet– even her own biological inheritance as a universal donor with type O negative blood becomes a potent metaphor for the mechanism of vaccination, a lens through which to view the permeable membrane between the biological and social truths of resistance. With an eye to the blood banks that collect her contributions to conserve other lives, she composes:

If we envision the action of a vaccine not just in terms of how it affects a single body, but likewise in regards to how it impacts the collective body of a neighborhood, it is fair to think about vaccination as a kind of banking of resistance. Contributions to this bank are contributions to those who can not or will not be secured by their own immunity. This is the concept of herd resistance, and it is through herd immunity that mass vaccination ends up being even more efficient than private vaccination.

It is a rather regrettable term for an undisputable scientific principle– we humans, specifically in this culture of rugged individualism nursed on the Emersonian ideal of self-reliance, bristle at thinking of ourselves as members of a herd. In our long history of thinking with animals, herd animals have been the butt of our negative metaphors for meaningless conformity.

Art by Olivier Tallec from Louis I, King of the SheepAnd yet inside the unfortunate linguistic container, an unfaltering biological reality resides: On large enough a scale, even a fairy inadequate vaccine that stops working to produce resistance in some people will slow down the spread of infection in the neighborhood; as the infection stops working to replicate itself in a growing number of brand-new hosts, the vaccine will eventually halt it completely. In effect, even such an average vaccine will secure all members of the neighborhood, even those for whom shot has actually not worked as intended on the private level. This is why it is more hazardous to be the immunized animal amid a mainly unvaccinated herd than the other method around. Biss composes:

The unvaccinated individual is protected by the bodies around her, bodies through which disease is not flowing. However an immunized person surrounded by bodies that host disease is left vulnerable to vaccine failure or fading immunity. We are secured not so much by our own skin, however by what is beyond it. The borders between our bodies start to liquify here. Donations of blood and organs move between us, leaving one body and getting in another, therefore too with immunity, which is a typical trust as much as it is a private account. Those of us who make use of collective resistance owe our health to our next-door neighbors.

With an eye to the origin of herd resistance theory– a theory established in the 1840s by a medical professional treating smallpox, which has taken manyfold more human lives than any other transmittable illness in the history of our types and which has actually given that been eliminated– Biss proposes an option, both more poetic and more precise, to the imperfect term that so completely explains the biosocial truth:

Herd immunity, an observable phenomenon, now seems implausible just if we think about our bodies as naturally detached from other bodies. Which, naturally, we do.
The very expression herd immunity recommends that we are cattle, waiting, perhaps, to be sent to massacre. And it welcomes an unfortunate association with the term herd mindset, a stampede toward stupidity. The herd, we presume, is foolish. Those of us who eschew the herd mentality tend to choose a frontier mindset in which we imagine our bodies as isolated homesteads that we tend either well or badly. The health of the homestead next to ours does not impact us, this thinking recommends, so long as ours is well tended.
If we were to exchange the metaphor of the herd for a hive, perhaps the concept of shared resistance may be more enticing. Honeybees are matriarchal, environmental do-gooders who likewise occur to be totally synergistic. The health of any individual bee, as we understand from the current epidemic of colony collapse, depends on the health of the hive.

Diagram of bee anatomy by French artist Paul Sougy, 1962. (Available as a print.) Biss prices estimate a concise summation by her dad, a medical professional:

In spite of the ethical and scientific denunciation of Wakefields research study, its ideological meme had actually currently spread beyond retrieval. (Richard Dawkins coined the word meme in 1976 by obtaining from biology– a word that came alive once again a quarter century later on in the context of “viral” material on the internet, which has its own roots in public health.) A quarter century later, echoes of Wakefields disproven fallacies wail with formidable vocality. That group of voices is typically described as the anti-vaccination movement, however I find the term movement exceptionally ill-suited– such groupthink is not in motion however fixed, frozen in time and frozen with worry, petrified in the cultural amber of a time before the Age of Reason and lashed about by the same errors of magical thinking, willful loss of sight, and confusion of causation and connection that made our middle ages forefathers take comets for unassailable omens of future occasions and left-handedness for indisputable evidence of possession by the Devil.

No one individual has actually done more to undermine this essential mutuality of defense than Andrew Wakefield– the British gastroenterologist who, in the 1990s, infected the hive mind with his causal claims linking vaccines and autism. Taking advantage of the understandable human impulse towards concretizing blame for amorphous and ambiguous problems, the theory went viral before multiple subsequent research studies exposed his results, prior to it was exposed that Wakefield was paid for his research study by an attorney preparing a claim versus a vaccine maker, prior to the General Medical Council of the United Kingdom concluded its investigation with the verdict that Wakefield had actually been “careless and unethical” in performing and releasing his work.

Vaccination works by enlisting a majority in the protection of a minority.

Art from The Comet Book, 1587. (Available as a print). Biss is more generous in her own evaluation of anti-vaccination:

Those who went on to utilize Wakefields inconclusive work to support the concept that vaccines cause autism are innocent of lack of knowledge or science denial even they are guilty of utilizing weak science as it has always been used– to provide false credibility to an idea that we wish to think for other factors.

Composing soon after the birth of the Occupy movement– the self-described “99%” introducing “an ongoing worldwide demonstration of commercialism”– she considers a friends half-joke, half-koan about vaccination as a matter of “inhabit immune system,” and reviews the basic ethical syllogism of anti-vaccination as a political stance declaring to oppose the capitalist forces behind modern-day medication:

Immunity is a public space. And it can be occupied by those who select not to bring immunity. For some … a refusal to immunize falls under a wider resistance to industrialism. But refusing resistance as a type of civil disobedience bears an unsettling resemblance to the very structure the Occupy motion looks for to interrupt– a privileged 1 percent are protected from risk while they draw resources from the other 99 percent.
[…] We are justified in feeling threatened by the unlimited expansion of market, and we are warranted in fearing that our interests are secondary to corporate interests. Refusal of vaccination weakens a system that is not in fact common of industrialism. It is a system in which both the burdens and the benefits are shared across the whole population. Vaccination enables us to utilize the products of capitalism for functions that are counter to the pressures of capital.

Emissary by Maria PopovaIn a charming antidote to the awful human tendency towards cynicism– that inefficient and touchingly misdirected effort at self-protection, that particularly virulent pressure of cowardice to which our culture has actually grown significantly hospitable as it has actually grown increasingly restless with the sluggish and vulnerable work of nuance– Biss adds:

If we imagine the action of a vaccine not just in terms of how it affects a single body, however likewise in terms of how it impacts the cumulative body of a neighborhood, it is fair to believe of vaccination as a kind of banking of immunity. This is the concept of herd resistance, and it is through herd immunity that mass vaccination becomes far more effective than specific vaccination.

That a lot of people discover it totally possible that a huge network of researchers and health authorities and physicians worldwide would willfully hurt children for money is proof of what industrialism is actually taking from us. Commercialism has already impoverished the working people who create wealth for others. And industrialism has currently impoverished us culturally, robbing unmarketable art of its worth. However when we begin to see the pressures of industrialism as inherent laws of human inspiration, when we start to believe that everybody is owned, then we are really impoverished.

Enhance On Immunity– a salutary and redemptive read in its whole– with Virginia Woolf on disease as a portal to self-understanding and Bessel van der Kolk on the science of how our minds and our bodies assemble in recovery, then revisit Adrienne Rich on withstanding industrialism through the arts of the possible.

Contributions of blood and organs move between us, leaving one body and entering another, and so too with immunity, which is a typical trust as much as it is a personal account. The very expression herd resistance recommends that we are cattle, waiting, maybe, to be sent out to massacre. If we were to exchange the metaphor of the herd for a hive, maybe the principle of shared immunity might be more enticing.