- MutationsThe Power of Metaphor in a Pandemic
science, pandemic, medicine, health, vaccine, virus, metaphor
Has there ever been a disease so intensely studied and so intensely controversial as Coronavirus Disease 2019? We have come to know more more quickly about COVID-19 than we have about any pandemic-causing pathogen in history. The genetic sequence of the novel coronavirus was uploaded to an open-access database by scientists from the Shanghai Public Health Clinical Center on January 11, 2020. Within two days, scientists at the National Institutes of Health in Bethesda, Maryland, and at Moderna Therapeutics in Cambridge, Massachusetts, used the sequence to create the blueprints for a vaccine that would be delivered into people's arms in just over a year's time. The effort was part of the US government's "Operation Warp Speed," and led to what was considered "the fastest vaccine ever developed." Remarkably, according to the US Centers for Disease Control and Prevention, the mRNA class of vaccines was also found to be 94 percent effective at preventing symptomatic COVID-19 infection in pre-variant trials, with a relatively low risk profile. With these and other therapeutic breakthroughs, we now have precisely the kind of treatments that, as Susan Sontag argued in her seminal book, Illness as Metaphor, lead to the demystification of disease.
The question on everyone's mind, now that hopes for achieving herd immunity or COVID-zero have vanished, is how do we get enough people vaccinated to reduce hospitalization and death from the virus? Data has been bandied about to help people see the scope of the problem and the usefulness of the injections. But data alone doesn't seem up to the task of dissolving misconceptions. According to the Kaiser Family Foundation, "Trust in government sources of information is especially low among those who say they will 'definitely not' get the vaccine." That mistrust has been compounded by conspiracy theories trafficking in a similar valence of misinformation. As an Economist/YouGov poll found in May 2020: "Three in five vaccine rejectors believe that infertility (62%) or changes in a person's DNA (60%) could occur with the vaccination." Half of those surveyed thought the vaccine caused autism; half also thought the vaccine included a microchip. Unsupported beliefs, all.
So, in addition to data, and in keeping with the traditions of public rhetoric, political leaders and scientists turned to metaphor. Back in March, President Joseph Biden enlisted the language of patriotism, tethering the quest for vaccination to the idea of national independence. "After this long, hard year," Biden said, "[getting vaccinated] will make this Independence Day something truly special where we not only mark our independence as a nation, but we begin to mark our independence from this virus." As we now all know, despite remarkable progress, the nation fell just short of Biden's goal of having 70 percent of adults vaccinated with at least one shot by the Fourth of July (though it should be noted that rates of vaccination among those over age sixty-five is admirably high in some states).
Is it possible to understand the persistent lag in vaccination rates as a function of [End Page 136] failed metaphor? That is to say, as a failure of language—the language of data, the language of science, the language of political rhetoric (to name just a few vocabularies)—to meet individuals at their particular coordinates on the social map? The virus and our national response to it has been figured and refigured. Yet the hardcore hesitant remain skeptical, if not obstinate. How much is this a function of a particular metaphor's limitations, versus the social limits of metaphor in general? These questions aren't meant to undercut real concerns about structural inequities that govern resources and access to vaccines, but they are designed to expose subtler barriers that exist alongside these undeniable realities.
Before trying to answer such questions, though, it's useful to look beyond the high stakes of the current pandemic toward the way clinicians regularly use metaphor to translate medical concepts for their patients. Antibody-antigen binding, for instance, is often equated...