The End World Medicine?

by Andrew N. Rubin

April 11, 2020

On March 16, the editor-in-chief, as well as the two deputy editors of the Journal of the American Medical Association (JAMA) wrote an editorial on the poor quality of the hundreds of submissions, case reports, case studies, and reviews related to COVID-19 that its editors had received since January 1, when the journal first started reporting on the the deadly new virus, SARS-CoV2. Its editors observed that over the past two months JAMA had been receiving multiple articles possibly describing the same patient, creating “an inaccurate scientific record” that threatened to undermine the accuracy of future estimates of the “prevalence of the disease and outcomes.”

The editorial on “Possible Reporting of the Same Patients With COVID-19 in Different Reports” went on to claim that this careless research had possibly grave consequences for the nation’s response to the pandemic:

“The potential for harm that could accrue from this type of misleading reporting is particularly concerning for studies of COVID-19. They are related to a rapidly evolving pandemic with only limited information available for decision-making, so that inaccurate data and analyses not only affect understanding the disease and its epidemiology, but have the potential to result in inappropriate changes in clinical care, ineffective public health responses, exacerbations of the economic consequences from this epidemic, and increasing anxiety about the pandemic.”

While there is a “limited amount information available,” the medical understanding of this pandemic should by no means be inherently restricted to a body of research written in the English language. To date nearly 80,000 people have recovered from the SARS-CoV2 in China, and since the outbreak, Chinese researchers have had more time to analyze the data to generate an archive of knowledge that remains largely unavailable to physicians and researchers who lack knowledge of that language. In South Korea as well, the government enacted measures that limited the infection to 10,331 people out of a population of 51,780,579, of whom only 192 died. In the United States, which has a population 325m, 22,000 people have already died.

Ding Yanqing,  Bian Xiuwu, “Analysis of coronavirus disease-19 (COVID-19) based on SARS autopsy,” Chinese Journal of Pathology, 2020, 49(04): 291-293

Scientific and medical research must draw upon the whole history of existing medical knowledge that has been published in all the world’s languages: Chinese, French, German, Italian, Japanese, Korean, and Spanish—the official languages the countries in which a great deal of COVID-19 research has already been conducted. In several instances, the World Health Organization published articles in French, but failed to translate them into other languages.

Ignoring the scientific record of the history of the human experience of this pandemic not only impoverishes our understanding of the disease, but comes at a great expense to human life, as national groups of physicians possibly discover what medical and scientific researchers may have already described elsewhere.

If the nation, and not the planet, remains the repository of scientific and medical knowledge, our understanding of human history, to say nothing of the understanding of ourselves as a species, risks becoming limited to a mind-set that fails to recognize the overlapping human, planetary terrain upon which this pandemic, and our shared fate as a species, rest.