Clean in a time of coronavirus

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“I don’t know how people come up with these political books that they seem to push through really quickly,” James Hamblin, a doctor and writer for The Atlantic, said the other day. In January, Hamblin put the finishing touches on his new book—Clean: The New Science of Skin, about the skin microbiome and the cleanliness-obsession industry—knowing that it required several months of lead time before it would be released. By mid-March, however, as the world we once knew dissipated, he was worried that the book would seem totally out of date. In it, for instance, he writes at length about the pitfalls of soap. He emailed his publisher to ask about inserting context on the pandemic. “I’m like, if you want me to add a prologue—or try to add a chapter, even,” he said. “I don’t think we’ve written dangerous things in there that don’t stand up. But it just seems weirdly conspicuous. And especially by July, like, we won’t even remember a world without the coronavirus.”

He got an answer back: Nah, it’s fine. The book was copyedited and fact-checked. “We added one sentence that was just, like, this book was written and reported before the coronavirus,” Hamblin said. Clean comes out this week. He’s happy with it. “I think the book is clear about the importance of hand washing,” he explained. “And I think the idea of targeted hygiene really holds up also, because of the shortages we’re facing right now. We don’t have the luxury of concluding that more is better when it comes to Clorox wipes or hand sanitizer. We have to think, Exactly who needs this most?

Hamblin, who is thirty-seven, with a boyish face and a poof of blond hair, spoke over Zoom from his apartment, in Brooklyn. He wore a gray shirt; there was a bookshelf with a plant behind him. He’d been busy in the months since finalizing his book. In February, while the pandemic was still, in the American imagination, a far-flung tragedy, he wrote a piece for The Atlantic, “You’re Likely to Get the Coronavirus.” It contained a prediction that between 40 and 70 percent of people would eventually become infected. The article went viral; it angered nonbelievers and was a foghorn for those who saw what the pandemic was becoming. “That headline was very deliberate,” Hamblin said. “But the Associated Press said that I was fearmongering. I went on some TV shows and they’re like, You’re likely to get the coronavirus—here in New York City? Come on!” He wanted to be taken seriously, but it was hard getting people to accept his warnings. He’d been talking to pandemic modelers; he’d covered Ebola. People in China couldn’t leave their homes. Soon, in Italy, weddings and funerals were banned. “We were starting to debate whether you should cancel Coachella,” he said. “I was living for a while in this parallel universe of—it was very clear, it was happening in every country. Why would we think we’re exceptional? I almost had an aneurysm trying to get this across.”

James Hamblin. Photo courtesy of subject.

Hamblin continued to write extensively about the coronavirus. In March: “What Will You Do If You Start Coughing?” In April: “Why It’s Important Not to Drink Bleach.” In May: “Is Everyone Depressed?” He also started a pandemic-focused podcast, Social Distance, with his Atlantic colleague Katherine Wells. In one episode, he spoke with Ed Yong, who has likewise delved into the coronavirus story for The Atlantic. (“Most people I’ve spoken to who think about public health and preparedness talk about this concept of cycles of panic and neglect,” Yong said. “So guess which one we’re in now.”)

Hamblin, who in his spare time lectures at the Yale School of Public Health, didn’t plan on becoming a journalist. Originally from Munster, Indiana, he went to the Indiana University School of Medicine and wound up in the radiology lab. He found it kind of dull. “It was really difficult for me to sit in a dark room all day, every day, reading X-rays,” he said. “It was really academically interesting, but the practical day-to-day of doing it was depressingly isolating.” He took some time off, started writing, and applied for a job covering health for the Atlantic website. It was 2012, and the magazine’s site was small enough that the editors were willing to take a chance on him. “Even though I didn’t have journalism experience, you know, I had a lot of knowledge of the beat,” he said. The work was thrilling. “I was just really intellectually and creatively fulfilled.” Later, he completed a residency in public health and preventive medicine. “I am board certified,” he explained. “I don’t prescribe pills for patients, but I practice through media.”

In Hamblin’s view, if you want to improve people’s health, it requires more than making a diagnosis on a CT scan. “What would really change things is to get much more to the root of the problem,” he said. Good healthcare requires both medicine and information on how public health works, so that people are empowered to manage their own care. “I’m part, hopefully, of the people who are on that initial information side,” he said. “And that’s what journalism does, which is to not necessarily tell people what to do but to help everybody make sense of it all.”

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Clean originated with a piece Hamblin wrote in 2016. The skin care industry was on the rise. Some consumers were beginning to look beyond the marketing schemes that govern the beauty industry and check out the science that backed it up (or didn’t). Products containing probiotics—bacteria—were becoming popular. Hamblin was skeptical about what they meant for the microbiome of a person’s skin. “You can’t continue to tell people they need to be clean and also you need to be applying bacteria,” he’d thought. At the time, he was living alone. He decided to try an experiment: no soap in the shower. (He still took water-showers and used his hands to rub away sweat and grime; he never stopped washing his hands.) His essay describing the experience, “I Quit Showering, and Life Continued,” blew up. “The feedback I got to it was intense,” he said. “I’m not saying good.” It was clear he’d hit a pressure point, and in hindsight Hamblin sees why: people shower to keep clean, but we do it for lots of other reasons, too. He’d never before considered the political and cultural implications of what we call cleanliness; readers pointed out that the world has long held white men to different standards when it comes to their appearance than most anyone else.

Hamblin realized there was much more to say on the subject. Clean begins with his experiment ditching soap in the shower, but it’s really a book about the entanglements of beauty and hygiene, marketing and cultural norms, the science of cleanliness and the joy of self-care. “I honestly had never thought about this distinction between cleanliness and hygiene,” he told me. “It’s not because I had a different belief, it’s just because I’d never really interrogated the concept.” His book does not recommend that its readers follow his lead and stop using soap in the shower. He just wants us to reconsider what it actually means to keep clean and to scrutinize the products we buy in pursuit of that goal. In the end, he realizes, obsessive cleanliness does not always equal good health. 

That conclusion feels less true in these days of covid-19. But Hamblin hopes readers appreciate the distinction between diligently washing their hands during a global pandemic and spending excessive money on harsh detergents masquerading as body wash. “A lot of people are experimenting with not showering now because of the stay-at-home orders,” he said. “So maybe it’ll speak to people in that way.” Since the outbreak of the coronavirus, he has been jumping in the shower for a different reason. “I have been showering more because I need some kind of time-setting ritual,” he said. “Because there is no other thing to mark beginnings and ends.”

ICYMI: It wasn’t easy to describe The Outline. That’s what made it great.

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Alexandria Neason is CJR's Staff Writer and Senior Delacorte Fellow. Previously, she was a reporter at the Village Voice and covered education for the Teacher Project, a partnership between Columbia Journalism School and Slate. A team she worked on won the 2016 Education Writers Association award for news features. Follow her on Twitter @alexandrianeas.