If an infection killed a dozen or more people at one time in a specific location, health care workers, epidemiologists, and other scientists would rush in to try to find the cause. We would provide support, prevention measures, any mitigation possible to reduce spread of the infection. If we couldn’t find the cause, we would work to protect those most at risk. Whether the cause was environmental, genetic, microbial, or psychiatric, we would feel compelled to intervene in the most effective and compassionate way. This is exactly what has happened with COVID-19 and with other horrible infectious conditions, such as Ebola, tuberculosis, and SARS. The strategy is always to manage the most acutely affected, reduce the likelihood of further contamination, study the condition to understand its most dangerous characteristics, and begin to look for a cause.
We also do all that we can to support and treat those in need and those around them. These systems of care are never perfect until we find the intervention that is curative. But in the real world of health care, we always approach the problem with critical questions: How many could be saved? What could minimize damage? How do we treat those who survived? Is there need for post-acute care and rehabilitation? Can we find the cause? Every health provider knows this approach very well — especially in mid-2022, after two years of tangling with COVID.
Uvalde, Texas. Buffalo. Newtown, Conn. Laguna Woods, Calif. Las Vegas. Orlando. Pittsburgh. These cities all have a common occurrence — a lone gunman went on a mass shooting spree, resulting in multiple deaths and serious injuries.
We approach each of these events with grief and awe, provide some emotional support for families and survivors, put our heads down, and go back to our lives. And then some weeks or months later, the event is repeated. More people die. More families are left to deal with the horror of loss. The media tell the story. And usually, some survivors recall Newtown or Parkland and continue to fight and keep the issues in front of the public and the politicians. And then, with each new shooting, the number of tragic voices shouting out for help and preventive measures continues to grow. We are touched by these voices for the most part. If they get too intense or direct, we shy away a bit because of the discomfort we feel. And yet we continue to fear for our children and our families.
The contrast between these two infections is striking. What if we collectively treated these massacres as a violent and virulent infection? What if we asked: Despite conversations occurring over many years, why have we failed to determine the cause? Should we treat this like a disease that is spreading? Should we work on interrupting the most focal cause (gun violence) and work backward?
Some say that any type of gun control (even background checks) is worthless. Have we tried to test that theory? Other countries have done so with success. What if we saw that the rate of mass gun violence was reduced with a few first steps at gun control? What could we learn? What if we brought scientists, governmental leaders, health providers, and law enforcement together as key stakeholder groups and focused on short wins while providing the financial support to find the root causes?
Testing the effects of gun control is the logical first step in this “clinical trial.” Whether the root cause of this type of gun violence is discoverable, reducing the number of these horrible incidents by 20 percent, 30 percent, would be a big improvement. Suppose that access to guns is part of the chain of events that leads to massive deaths. Simultaneously studying other measures and causes would also be helpful. Investing in the needed research through the National Institutes of Health, the National Science Foundation, and even educational organizations could begin to answer the most elusive questions.
There isn’t a single solution to reducing the disease of gun violence. However, when risks seem pervasive and cures seem impossible, the health care community focuses on what can be done for the patient, the family, and the community. Maybe it’s time to bring health care logic to the gun violence conversation. This is a model that has worked for centuries and has improved the world for all of us. Our children, families, and future are worth the effort.
Alex Johnson is provost and vice president for academic affairs at the MGH Institute of Health Professions.