This Is World War III

Albert Einstein is often credited to have remarked, “I know not with what weapons World War III will be fought, but World War IV will be fought with sticks and stones.” His comments of course alluded to the concern that the advent of nuclear power would spur the invention of destructive weapons that would cause mass destruction unlike anything witnessed in modern times.

Global nuclear war has thus far been (narrowly) averted, but mass destruction has arrived. More than 560,000 people have been killed. Economic devastation is rampant. Borders are closed. Businesses and schools are shut down. Factories have been forced to shift production to essential supplies.

Make no mistake about it: This is World War III. This time, nations are not at war with each other; instead, they are fighting the same enemy — and there are two of them.

One is invisible. It is amongst us all. Many of us give it shelter and help it grow. It knows no borders, holds no religion, speaks no language, and harbors no emotions. It is a virus powered by a genetic program allowing it to hijack human cellular machinery to promote its own survival and spread into all corners of our planet.

The other hides in plain sight. It functions synergistically with the virus. The more it spreads, the less we truly understand the virus, and the less prepared we are to effectively battle it. It is called misinformation. It is a cunning enemy, able to penetrate even the minds of unsuspecting, educated humans.

In this war, the soldiers on the front lines are everyday people. At present, their weaponry consists of masks, hand sanitizer, and distance; those who succumb to the second enemy relinquish these weapons and put themselves and their comrades in grave danger. Epidemiologists and public health experts are assigned radar duties, identifying future enemy surges. Microbiologists and immunologists are the strategists, studying the enemy and testing effective responses in a simulated laboratory environment. Pharmaceutical companies are the war machinery, urgently devising medications and a vaccine to protect the people, and to reap an enormous profit in return. Healthcare professionals are the last line of defense, desperately trying to save those who fall ill.

This perspective may sound like fantasy. It is real. Very real.

Most people do not understand that the second enemy is more dangerous than the first. Misinformation makes us susceptible to all kinds of future wars — long after the virus has been defeated. It is unsettling, then, that the war effort is disproportionately focused on the virus itself. Perhaps most concerning is that it is most difficult to defeat misinformation in democratic societies and in those that value individualism over the common good. In this way, it threatens the survival of a beautiful form of government that has shown incredible potential worldwide.

I woke up this morning and read the news as I routinely do. A feeling of depression began to sink in, as it has, on and off for the past few months. Undoubtedly, millions have had the same experience. In a nationally representative poll administered by the American Psychiatric Association, 36% of Americans state that the SARS-CoV-2 pandemic has significantly impacted their mental health. Generalized anxiety, depression, panic attacks, and suicidal thoughts are surely on the rise. “Why?” I thought to myself. Our lives have been upended. We are worried about our finances. We are anxious about the status of our education or jobs. We fear for our children’s future. Why? Because these emotions are normal in a war, let alone one that imposes social isolation when social interaction is needed the most.

Labeling this catastrophe “World War III” imparts a sense of urgency that is missing from our leadership, and it also helps us understand why we feel the way we do. It contextualizes and normalizes our emotions, as well as inspires a sense of personal duty to the cause. In World War II, citizen contributions were crucial to victory — ordinary Americans worked in war industries, rationed goods, and purchased war bonds. Even students dropped out of school to help take war jobs.

That is why I am perplexed when I see people gathering in large groups and not wearing masks — in the name of “liberty.” Who will be around to enjoy that liberty if we do not act now to protect one another? In comparison to the grave sacrifices made in prior wars by our forefathers, is it so difficult to temporarily change our lifestyle? The selfishness, ignorance, and arrogance of those who choose not to abide by basic public health guidelines deflates the morale of millions of Americans and further contributes to the feeling of depression. We all want our jobs back and our children back in school. We each have a civic duty to do what it takes to make that happen. This is what it means to go to battle in World War III.

I became a physician because I knew that nothing was more important than health, and I and my colleagues are proud to go to work each day facing this virus. But the front-line battles of this war are fought in communities all over the world: in grocery stores, in the workplace, in backyards, in living rooms, in bars and in restaurants, and every place in between. We need common sense laws and we need people to have the common sense to follow them. Without that, the front lines collapse, behind the scenes efforts are useless, and the healthcare workers who are the last line of defense will fall. Everything that we hold so dear will cease to exist.

I often wish I could bring everyone in the world into our hospitals. I wish they could see the looks of terror that I’ve seen in the eyes of my patients with COVID. The young emergency room doctor in tears, likely needing a ventilator soon, who told me he never thought he would be on the other side of the disease. The elderly, demented man, alone and isolated from his family, who may not survive to ever see them again. The father of two, struggling to complete full sentences, begging me to do whatever it takes to help him breathe. This is what a war zone looks like in World War III. Would that be enough to convince people to finally take this seriously?

World War I lasted four years. World War II lasted six. World War III, if science delivers and if people listen, could be much shorter. The economic fallout, and the unspeakable tragedy and devastation that results, will last for many years, as is common in a post-war society. But after that, there will be recovery. Even after 80 million people were killed in World War II, recovery eventually came. If we all do our part, we can make that happen while minimizing casualties along the way. As the African proverb presciently states, “If you want to go fast, go alone; if you want to go far, go together.”

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Dr. Saab’s Bio Below

Dr. Faysal Saab

Dr. Saab is an internist and pediatrician practicing hospital medicine in Los Angeles, California. His clinical interests include medical education, bedside ultrasound, and global health.