Michael Mina could have pursued a career as a potter. Or remained a Buddhist monk in Sri Lanka. Instead, he opted to become an epidemiologist, a profession that now has his head hitting the pillow around 4 a.m. each day for five hours of sleep. He spends the bulk of his time in his office — or rather, the coffee table jury-rigged into a standing desk in his Jamaica Plain apartment — searching for ways to ease the pandemic’s devastation and fielding a barrage of media requests.
But each week, amidst the thousands of e-mails he receives and the thousands of patients filling intensive care beds across the country, it is not the exhaustion that weighs most heavily on Mina. It’s the dejection.
“At almost every step of this pandemic, we have failed magnificently as a country,” the Harvard scientist said Monday. “And in ways that we just really didn’t need to fail.”
The country, and in particular this city, are home to some of the greatest public health experts in the world, many of whom have spent their careers preparing for a crisis like the COVID-19 pandemic.
But as the worsening outbreak drags into its ninth month and politics too often prevail over science, many infectious disease experts say they are increasingly disillusioned. The rush of adrenaline and resolve from the pandemic’s early months has given way to frustration and fatigue caused by those government leaders who have ignored scientific data, and a public that has often shrugged off — or been openly hostile to — informed guidance. As cases and deaths surge across the country, some feel they are screaming into the void.
“I’m just astounded by the dysfunction, the willingness to just stay the course as hundreds of thousands of people die, and the unwillingness to innovate in literally any way,” said Mina, an assistant professor of epidemiology at Harvard’s T.H. Chan School of Public Health, who has been advocating for widespread at-home rapid antigen testing since March, with little success. “I’ve realized that when we need to rise up as a country, we have truly no moral capacity to do it. It’s just the most mind-bending, complete ‘Twilight Zone’ experience that makes you ask why the hell we even bother.”
Early on, when the United States still had a chance at staving off the worst of the pandemic, many infectious disease experts put regular research on the back burner and turned their full attention to combating the deadly new coronavirus.
Dr. Caroline Buckee, a Harvard epidemiologist who specializes in mapping the spread of infectious diseases across vulnerable populations in low-income countries, pivoted her entire 11-person team to COVID-19 research last spring.
“We went from having this really stressful job to triple that. That was all right because there was this feeling that if we worked hard and produced science, we could really help. And perhaps we did,” she said, her voice trailing off.
By midsummer, researchers had learned enough about the virus to craft the general guidelines needed to keep it at bay. (Buckee jokes of printing T-shirts to wear on Zoom calls that read: “Wear a mask. Indoor dining is a bad idea. No large gatherings.”) It was then up to the politicians and the public to enforce and adhere to those guidelines, a process that has played out unevenly and often shoddily across the country.
“Although there are still many unknowns, a lot of the most decisive factors in the trajectory of the epidemic are now political and social,” Buckee said. “They’re no longer epidemiological. We understand the basic facts of how this virus transmits. We understand the types of interventions that are going to work until we have a vaccine.
“It’s now in the hands of regulatory bodies and bureaucracies and politicians. And the sense that we can work in partnership with them and really make a difference, it feels like that is now at an end. That was a demoralizing realization for many of us.”
After publishing over a dozen papers on the virus, Buckee stepped away from COVID-19 research to redirect her efforts back to tuberculosis and malaria — which together killed nearly 2 million people last year — diseases that will continue to rage long after a vaccine tempers the coronavirus threat. She also suspended her Twitter account after her feed, mostly consisting of pandemic advice and research, triggered a cascade of sexist and personal attacks that threatened her and her family.
It’s this urge among strangers online to lash out and threaten scientists that concerns Dr. Ashish Jha, dean of Brown University’s School of Public Health, even more than the public’s disregard for science.
“I’ve come to believe that we live in this very complicated society where voices like mine are heard and they are valued, but they’re not always listened to. And that’s probably OK to an extent,” said Jha, one of the most quoted public health experts through the pandemic. “Our job is to help people understand what the trade-offs are, but not necessarily to tell people what to do.”
He can count on one hand how many days he has taken off from work in the last nine months. All the while, scathing messages have poured into his office and inbox, criticizing him both personally and professionally.
“Just barrages of two-page letters telling me how awful a human being I am and how I should ‘go back to where I came from,’ ” said Jha, who was born in India and has lived in the United States since he was 13. “All that was pretty much par for the course, shocking at first but then I just ignored it.”
But then in late November, Jha testified before Congress about the inefficacy of hydroxychloroquine, a drug used to treat malaria and touted by President Trump as a “game changer” in the fight against the coronavirus. Shortly after the hearing, Jha said the threats lodged at him grew more serious and tangible, prompting him to alert police, who sent cruisers to patrol his neighborhood. The experience mirrors that of Dr. Anthony Fauci, perhaps the nation’s most well-known infectious disease expert, who has required a security detail for months following threats to himself and his family.
“That is probably the only moment in the last eight months that I wondered if I was doing the right thing by engaging in this profession. It’s never been the fatigue for me. It’s the question of would somebody harm my family,” Jha said. “Where are we as a country when that’s how people react to science?”
Many critics have reviled pandemic experts as finger-wagging doomsayers or “deep state” agents far removed from the realities of ordinary folks who are suffering from and fed up with COVID restrictions. But behind the lab coats and the academic degrees, they are also lonely, grieving, and stressed. They, too, wish things would return to normal.
Jha’s cousin died in Delhi when he suffered a heart attack and couldn’t be seen by a doctor amidst the coronavirus surge. Buckee, a single mother whose family lives overseas, is torn between her passion for science and the need to help her 8-year-old and 10-year-old with remote learning. Throughout the pandemic, female academics report having taken on far more child-care duties than their male peers, who are four times more likely to have a partner who is a full-time caregiver.
Dr. Sara Suliman, a tuberculosis immunologist turned COVID-19 diagnostics expert at Brigham and Women’s Hospital, was diagnosed with general anxiety disorder for the first time last week. Beyond taking on a workload that requires 100-hour weeks in the lab, she’s a Black woman who lives alone during an isolating pandemic that has disproportionately killed Black people. She’s an infectious disease expert who watched the historic crowds at Black Lives Matter protests this summer with a conflicting mix of personal pride and professional concern.
“Among my Black friends and family, there is hardly any one of them who doesn’t know somebody who’s gotten sick from COVID or died from it,” said Suliman, who was still at the lab at 8:30 p.m. this past Monday. “I don’t know why I watched the Breonna Taylor indictment but I did, and I carried it in the back of my mind for days. I showed up to work where people asked if I was OK. To which I’m like, ‘Of course I’m not, but also what are you offering?’ ”
She has resumed her research on tuberculosis while maintaining her role on a COVID innovation team. Her determination to forge ahead despite the disillusionment of this year is shared by the other infectious disease experts contacted for this story, a few of whom spoke of colleagues who had chosen to leave the field entirely.
Since pivoting away from the coronavirus, Buckee has already published two papers on malaria. With COVID hospitalizations surging across the country and the winter months promising further catastrophe, Jha continues to partake in the media grind although he has scaled down his appearances to just 15 to 20 a day, as opposed to the three dozen typical of the spring. And Mina, in all those hours spent not sleeping each week, continues his crusade to universally distribute at-home rapid tests.
“Why? Well, I don’t see any better options on the table,” he said, though he admits life would have been far less stressful if he’d just stayed a monk. “I just see a lot of people dying. And I really want this pandemic to stop. I really want people to not die so much.”