Yes, the World Health Organization Was Foolish – But We Desperately Need Each Other

A comment on Monday from the World Health Organization (WHO) suggested the likelihood that asymptomatic individuals can transmit virus was “very rare.” The WHO’s poor choice in these two words emboldened a fringe, those desperately seeking a magical “Undo” button to wipe out the lessons of 2020 and return us to the halcyon days of 2019.

I would politely suggest two different words to characterize Monday’s statement by the WHO: ignorant and stupid. This selection is not based upon raw emotion nor are these words redundant. Both descriptors have their place in this story but let’s review: ignorance reveals a profound lack of knowledge whereas stupidity reflects a situation of ignoring what you know. 

The WHO (and the rest of us in the scientific and medical communities) remain largely ignorant about who can or cannot transmit virus. Yet the WHO was truly stupid to convey what is clear: the virus is spreading faster than the level of overtly sick individuals would suggest. 

Without delving into the deep, dark chasms of microbiology or epidemiology, it suffices to say that our learning curve as it pertains to COVID-19 and the virus that causes it (SARS-CoV-2) is nearly a straight upward line. This should terrify everyone and explains Tony Fauci’s continued concern as expressed by multiple news outlets this week.

We certainly know much about other coronaviruses, informed by the comparatively benign infectious agents that are responsible for one in six common colds. We had also been warned of the potential lethality of coronaviruses but missed not one, but two clues, provided by nature. The first was the 2003 SARS outbreak followed the emergence of MERS in 2012.  

The WHO statement about asymptomatic spread of COVID-19 was inexcusable. We should accept that we are too ignorant to make stupid statements at this point; but the WHO did just that.

This same ignorant and stupid statement also betrays a crucial fact – we desperately need the WHO.

The WHO is comprised of many smart and well-meaning scientists buttressed by far too many politicians. The institution, like its parent organization, the United Nations, tends to be overtly bureaucratic and this has shown itself many times, such as during the COVID-19 outbreak when it stifled itself from challenging China about the breadth and severity in the early days as the crisis unfolded.

Nonetheless, the mission of the WHO is vital. Much as the DEW line in northern Canada and Alaska was created to detect incoming missiles from the USSR, the WHO detects disease outbreaks. Although viral and bacterial pathogens do not fly with the speed of a rocket, they routinely do so at the nearly supersonic speed of a commercial jetliner. 

For the most part, the system works. Experiences with multiple outbreaks of Ebola, Marburg, Chikungunya and many other viruses that never made the headlines were prevented or contained in no small part as a consequence of activities by the WHO. The WHO can itself serve as a superspreader, of information that is, alerting the best and brightest scientists around the world to potential threats and the means to prevent them.

We must also return to the examples of SARS and MERS. These two prior experiences remind us yet again of the limitations of, and need for, the WHO. In both cases, we let our guard down. 

Imagine the counter-factual that might have unfolded had we entered 2020 with a SARS vaccine that showed even modest cross-reactivity with SARS-CoV-2. The argument would likely have been who the world was inconvenienced while we scaled-up production and fought over which country would be immunized first, rather than the need to start such efforts from scratch.  Hundreds of thousands would still be alive today.

In 2003, the WHO alerted the world to the problem and the response was admirable. Yet, short-termism prevailed, and we eventually forgot about SARS. MERS popped up in 2012 and though the WHO and the public health infrastructure perked up for a time, the passage of time lulled us back into our blissful ignorance. 

Looking forward, the WHO needs to be less bureaucratic, less political, less ignorant and not at all stupid. The leadership at all levels of the organization should be reviewed after the current crisis has passed and in anticipation of the next. 

And there will be a next one as pandemic arise, on average, at least once a generation and we have encountered a particularly rough pandemic in about three generations, suggesting Mother Nature has more than a few curve balls heading straight for our nose.

Effecting change in the WHO will certainly not occur as a result of withdrawing support for the agency. Neither does this same administration (or any other) have the resources nor the will to build a new DEW line for microorganisms. Indeed, an under-funded but usually-admirable Centers for Disease Control and Prevention (CDC) has sullied its own reputation for years to come with its own missteps on diagnostic tools. Instead, we need to double-down on our commitment to the WHO (and CDC), calling out incidents of stupidity when we see them and making sure they are not repeated.