If we think of a disease as something that is sending us a message that we need to incorporate into our individual and collective lives, we get a much different view of the ongoing COVID-19 pandemic. So far, our attempts at integrating COVID-19 into our existence have been met with one surprising turn after another. The rapid rise of the Omicron variant is just the latest twist in the pandemic story. And, it follows the rise of the Delta variant which led to a previous new wave of infections.

The Delta variant seemed to increase significantly so-called breakthrough infections, that is, COVID infections in people believed to be fully or partially vaccinated, something which has flummoxed the medical community and public health officials. Still, those receiving a vaccine have far lower rates of hospitalization and mortality than those catching COVID who have not been vaccinated.

We don’t yet have enough information to know just how well vaccines will fare against the Omicron variant. One early report is creating concern. Cornell University has closed its main campus in response to a rapid rise in COVID cases caused by the Omicron variant. And, this is a place where 97 percent of the people on campus are said to be “fully vaccinated.”

We do know that protection from COVID vaccines fades with time (usually within months) and hence the emerging recognition of the need for frequent boosters. And, the public now understands that vaccines neither guarantee freedom from infection nor prevent those vaccinated from spreading the virus even if they are asymptomatic. Risk of individual infection and community spread is considerably lower, but it is not zero. The easy-to-spread Omicron variant is doubling its cases every 1½ to 3 days.

Against this backdrop I highlight two important facts that we know about COVID’s effect on humans: 1) The mortality rate of those with underlying conditions such as diabetes, heart disease or obesity who contract COVID is about four times higher than those without such conditions and 2) around 40 percent of all COVID cases are asymptomatic.

It’s no surprise that those compromised by underlying conditions find their systems so overwhelmed that many of them die. What is not clear is why so many who are infected do not manifest symptoms. This would be a key question for public health researchers. So far they are interested in this group because controlling the spread of COVID is complicated by the fact that so many people infected with the virus do not know it. They are therefore far less likely to take the same steps that obviously sick persons take to protect others.

But it would also be important to analyze the health habits, lifestyles, working conditions, demographics and other characteristics of this population to find out if there are patterns that shed light on their ability to withstand infection unfazed. This ought to be a key priority for public health. So why isn’t it?

Part of the explanation according to this piece in The Atlantic Monthly is that broad concerns such as poverty, housing, working conditions and sanitation that used to be central to public health have been largely discarded. (I would add diet to this list as well.) The model that replaced it puts the emphasis on individual biomedical interventions such as antibiotics and vaccines. Lost is the understanding that we humans are organisms in an environment with myriad forces operating on our health.

What public health used to focus on is now found in what is called “community medicine” which is defined as “[a] branch of medicine concerned with the total health of the individual within the home environment and in the community, and with the application of comprehensive care to the prevention and treatment of illness in the entire community.” This is a far cry from the illness care model that dominates the health field.

Part of the problem according to the Atlantic Monthly article cited above is that the old model of public health puts public health officials in the position of advocating broad social change. That can make for short careers or marginalization these days. And the current largely biomedical model is maintained by credentialed public health professionals. The broad coalition needed to improve basic environmental and social factors affecting health is mostly outside the profession.

In addition, we humans know that our bad health and lifestyle habits can lead to bad outcomes. Poor diet, lack of exercise, mental stress, and lack of meaningful relationships can result in breakdown. It is a testament to our inability as a society to integrate this knowledge that such diseases as diabetes, heart disease and cancer—all of which are closely linked with health and lifestyle habits—continue to dominate the mortality statistics in the United States (2019) and in other wealthy countries such as those comprising the European Union (2017).

Ubiquitous advertising by the food industry and the pharmaceutical industry surrounds the public with messages that tell them they can eat whatever they want and that pills can solve all their health problems.

Much of the focus in addressing COVID has been on vaccines as a silver bullet. It should now be clear even to the most enthusiastic vaccine booster that COVID must be addressed through a broad array of measures and changes in society—changes that would help us weather the next pandemic for which there will by definition be no immediate vaccine. In short, robust health is our first and best line of defense.

Many readers who have experienced a serious health crisis know that getting well can require dramatic changes in diet, exercise, work and general outlook—a reordering of priorities and a revamping of daily practices. Such crises can turn into a path of personal growth and lead to a more satisfying life. But it takes work, focus and the flexibility to discard old notions that are counterproductive.

Global human society is having a serious health crisis as a whole. Our leaders keep insisting that we will get past it shortly and go back to normal. But the crisis keeps returning in new and surprising ways, in part because our “normal” way of life was already fragile and crisis-prone.

So what is COVID telling us? As previously stated it is telling us first and foremost that we are organisms in an environment. If we want to harmonize with that environment, we will have to do more than simply try to kill or prevent the propagation of one of its tiniest inhabitants. The project we are faced with is nothing short of reintegrating our way of being with the natural world of which we are an indissoluble part. This is especially important in light of the fact that COVID will almost certainly become endemic, that is, it won’t go away but rather continue to circulate and infect people indefinitely.

Our current institutions run counter to a reintegration with the natural world. This applies both to the pandemic and to other critical issues such as climate change, soil degradation, and ocean pollution to name just a few. We humans are altering major natural systems in ways that undermine their stability and their capacity to provide us with what we need to live and thrive.

In practically every area of global life, humans are doing the equivalent of eating potato chips and ice cream while lounging on the couch and calling this a complete and balanced diet and exercise program. If we want to adapt to COVID and address the other major challenges to our survival as a species, we will have to break free of the notions that we can conquer and/or ignore nature. We will need to rediscover how we can come into harmony with a natural world that keeps sending us ever more dire and forceful messages to adjust our course.

Image: Part of a giant traditional Chinese painting. Chen Minglou. 2007. Via Wikimedia Commons https://commons.wikimedia.org/wiki/File:A_part_of_Giant_Traditional_Chinese_Painting5.jpg