“Survival of the fittest” is a phrase I have come to loathe. This manner of thinking is particularly appalling to hear as a sickle cell patient. I have heard the phrase more frequently lately, against the backdrop of the current COVID-19 pandemic. But what does it mean?
Historically, the phrase was derived from Darwinian evolutionary theory and speaks to the process of natural selection. Natural selection states that characteristics advantageous to the survival of a species are passed down to future generations at the expense of less dominant characteristics that eventually die out.
Ironically, it has been theorized that the origins of sickle cell disease stem from natural selection. According to the theory, long ago, malaria crippled Africa and the Middle East, and the human body’s response was to adapt to its environment by mutating to protect itself.
People who have this protective mutated gene are described as having sickle cell trait. For the most part, sickle cell trait can be harmless, and members of this group can live relatively normal lives. (And yes, after all these years they are still less inclined to develop malaria.)
But when two people with these mutated genes have children, each pregnancy has a 25% chance of the child developing sickle cell disease.
With this in mind, it is evident that we sickle cell patients did not make ourselves sick. So, you can understand our frustration when people use Darwinism to imply that because we have weakened immune systems, our lives are somehow lesser in value than others. Even in the scenario in which someone contracts an illness due to their lifestyle choices, I think it is wrong to devalue their humanity with such rhetoric.
The U.K.’s initial response to the coronavirus pandemic was to pursue herd immunity, a strategy admitted to back in March by the government’s top scientific adviser. Yes, you read that correctly. For an at-risk patient like me, the initial response seemed to be, “If we enable the virus to spread, large parts of the population will develop an immunity to it. Yes, some people will die, but it will only be a small number.”
Additionally, the initial global narrative about the virus that causes COVID-19 was that it is like the common flu, with mortality linked mostly to the immunocompromised and the elderly. The belief that large segments of the population would be unaffected meant that those who are at risk of developing severe illness from COVID-19 were left feeling as if they are disposable.
Why should I, and others like me, have our humanity diminished because of circumstances we have no control of? As if that weren’t bad enough, these comments allowed complacency to settle in people’s minds.
It soon became apparent that many of these assumptions were wrong. We all need oxygen to live, not just the elderly and the immunocompromised. Our respiratory systems work to ensure our bodies receive adequate oxygen. The COVID-19 virus attacks the respiratory tract.
Additionally, different things can affect the performance of the immune system, such as diet, weight, sleep patterns, and stress.
Consequently, it makes sense that everyone should be taking the new coronavirus seriously, and we should have been doing so from the start. Children and healthy adults have died from COVID-19, and we also have seen cases of elderly patients recovering fully from the disease.
In the U.K., a TV advertisement emphasizes that COVID-19 is potentially life-threatening to anyone who contracts it, since so little is known about the disease’s trajectory in patients. The advertisement adds that anyone can catch and spread the coronavirus.
This new messaging is vital, and I hope similar warnings are being communicated globally. But sadly, it seems that it may take a while before the initial misguided narrative of COVID-19 is completely corrected.
Going forward, I hope everyone will think twice before making sweeping statements about viral outbreaks. I also hope that the humanity of those who are immunocompromised — or any group of people — is never devalued in such a dreadful manner again.
Note: Sickle Cell Anemia News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Sickle Cell Anemia News or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to sickle cell anemia.
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