ACR Keynote: Camus’ ‘The Plague’ predicted ‘every part’ of COVID-19 pandemic

PHILADELPHIA — Looking not only to history, but also to narratives like novels and movies, can help health care professionals understand and move beyond the COVID-19 pandemic, according to the keynote speaker at ACR Convergence 2022.

“It is important that our leaders be well-versed in history,” Abraham Verghese, MD, Linda R. Meier and Joan F. Lane Provostial Professor of Medicine at Stanford University, told attendees. “But if you read ‘The Plague,’ by Albert Camus, you could have anticipated every part of the pandemic.”

Verghese is not just an infectious diseases clinician, but also a successful novelist and storyteller in his own right. He noted that Camus’ 1947 novel predicted vaccine deniers, misinformation about therapies, that some people would ignore the existence of the virus, and the backlash to those on the front lines of the fight.

Moreover, Verghese suggested that there are strong parallels to be made between COVID-19 and “monster stories,” such as the film “Jaws.” Understanding how these stories played out in the fictional realm can be instructive for how to deal with the “monster paradigm” that COVID-19 has presented, he added.

“We lived through this particular story, so we might as well be sure we understand it,” Verghese said.

“First you need a monster who is undefeatable,” he added. “The monster must be appeased every day by human sacrifice.”

In this case, daily news reports and multiple websites tracked local, state, national and international infection and mortality rates associated with COVID-19.

“The monster was being fed every single day,” Verghese said.

The monster also needs allies. In the present scenario, “great political unrest” led to increased challenges for the health care community in its attempts to control the virus, he added.

Meanwhile, political divides led to misinformation about rheumatology drugs that caused shortages for patients, according to Verghese.

“There was misuse of many drugs that were so vital to your patients and mine,” he said, adding that skepticism regarding COVID-19 vaccines was also a tremendous hurdle for physicians to overcome. “The monster was tremendously potent.”

Of course, Verghese suggested that every monster story needs a hero.

“There is one individual who steps forward,” he said. “They have belief and faith. They can martial forces and weapons. When they combine that with belief, they finally conquer the monster.”

Verghese was clear in who he believed the heroes of the COVID-19 pandemic to be.

“The heroes and heroines of this story are all of you,” he said. “All of you in health care.”

Once the monster is defeated, or at least controlled, the next phase of the story is that a “new order” is formed, according to Verghese.

“It is never the case that things go back exactly the way they were,” he said.

The shift toward telemedicine in clinical practice and virtual presentations at meetings like ACR will have a permanent and profound impact on rheumatology, Verghese added.

“We will never quite be the same,” he said.

Looking further afield, Verghese mused on how history will judge the reaction and response to the COVID-19 pandemic.

“We will get mixed reviews,” he said.

On the positive side, Verghese believes that the science will be seen as “phenomenal.”

“Within a few weeks of the outbreak, we had people working on the genome,” he said.

He added that the speed with which therapies and vaccines were produced will earn the scientific reaction to COVID-19 an “A+” in the history books.

“On the other hand, history will be very harsh with us about our failure to learn the lessons of history,” Verghese said.

Specifically, this failure comes, in part, from neglecting to heed the lessons learned from the AIDS epidemic, he said.

However, this should not deter rheumatologists from continuing the fight and making the most of the “new order” that has emerged post-pandemic.

“We must all heed the call to adventure,” Verghese said. “We need to have courage, have faith. We need to tell our story.”