Biology Is Not Destiny
Not a single expert could imagine that the global pandemic was just weeks away, and that the most critical weapon the authors would have in the fight against the spread of the coronavirus would be social distancing and mask wearing.
Abstract
That biology is destiny is among the most durable scientific myths because it is so easily embraced by both scientists and nonscientists. When Francis Galton introduced the term “eugenics” in 1883, he claimed that health and disease, as well as social characteristics and cognitive ability, were based upon heredity, introducing at the same time the erroneous concept of race as a genetic construct [1]. Eugenics gave a veneer of respectability to racist claims that individuals and groups of people could be determined to be superior or inferior and that the application of genetic principles could lead to human improvement. American eugenicists from several disciplines declared certain people unfit, or “feebleminded,” leading to the involuntary sterilization of more than 60,000 Americans through at least 30 different states’ laws by the 1970s [2]. Even one of the nation’s leading jurists, Oliver Wendell Holmes, Jr., fell victim to this misunderstanding when he approved the involuntary sterilization of Carrie Buck, with the statement, “Three generations of imbeciles are enough” [3]. More recently, we have seen the consequences of the myth of biology as destiny in the individual and population level response to the coronavirus epidemic. In the December 5, 2019 issue of the journal Nature Medicine, and just weeks before the emergence of the coronavirus pandemic, 11 experts were asked to imagine what they saw as the most important challenges facing Medicine. Reflecting in part the choice of respondents and in part the prevailing scientific opinion, the challenges were all viewed through the perspective of genomics and the rapid computational advances enabling the development of “big” data science to identify the primary causes of human disease [4]. Here are some representative comments: “For many years, biology and disease appeared “too big” to tackle on a broad scale. . .but now we are on the cusp of an inflection point, where the bigness of biomedicine turns into an advantage.” One expert anticipated a cataclysmic global pandemic but called out advances in genomics and information sciences as capable of transforming our fight against viral threats [4]. Not a single expert could imagine that the global pandemic was just weeks away, and that the most critical weapon we would have in the fight against the spread of the coronavirus would be social distancing and mask wearing. To its infinite credit, biomedical science rose to the challenge and triumphantly produced a vaccine that was highly effective against the rapidly mutating virus, and treatments that saved many lives [5, 6]. And yet, not one expert imagined that the greatest threat to efforts to control the pandemic would be misinformation, denial of the severity of the disease, and the importance of adherence to behavioral and cognitive strategies that were fundamental to acceptance of the social interventions and the biological interventions of the vaccine and later antiviral medications.