‘Nothing makes sense in biology, except in the light of evolution,’ the splendidly named biologist Theodosius Dobzhansky wrote in 1973. It’s a good rule of thumb. Despite near-miraculous advances in medical science we remain biological beings, subject to biological laws. None is more central to our understanding of disease than evolution. Yet this theory remains poorly understood and poorly utilized in medicine. And an evolutionary perspective raises important questions about the drastic action we have been taking to confront COVID-19.
Most doctors are too busy dealing with the day-to-day deluge of cases to have much time for what they may consider abstruse academic ideas. I can see why: it’s hard enough to understand diseases, let alone think about how they might be changing as we watch. But we know a lot about viruses and their evolution, and this perspective seems relevant (if largely overlooked) now.
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