I used to worry about the threat of nuclear war. It was concerning that so many countries had world-ending weapons sitting around. But recently I updated my mental list of top threats to put pandemics at the top. The 2019 novel coronavirus is still spreading as I write this. I'm concerned, but regardless of how this crisis plays out, watching the global response during the first few weeks of 2020 made me aware of how deeply unprepared we are to deal with this type of threat.
I am not an expert on this topic. Many of my recent realizations are probably well-known to those who have studied it longer, but I thought it would be worth writing down my thoughts on the risks and their possible mitigation.
Pandemics are not a new threat. Throughout human history, plagues and epidemics have caused massive amounts of destruction, at times wiping out large percentages of the population. Despite the lack of world-shaking pandemics recently, I think we are now at even greater risk in the 21st century because:
We are more connected and interdependent than ever before.
We have recently acquired the ability to genetically engineer microbes and wage biowarfare, but have no experience in controlling its consequences.
We have waged war against microbes and won for a century, but our victory is incomplete and we may become overconfident and underestimate risks.
This century could be defined by how we handle microbes of mass destruction.
Connected and Interdependent
We still have different countries and cultures, but our world is a single tightly interlocked system of global supply chains and interdependent trade relations. Stopping the constant flow of goods and people would paralyze the economy. Markets depend on the free flow of international trade. Few cities or regions have the resources to sustain themselves locally under conditions of extended quarantine. The disruption or collapse of global supply chains would cause critical shortages. Given these circumstances, it's understandable that authorities are reluctant to take measures to isolate their populations from the uncertain but extremely dangerous possibility of a global pandemic. If we can't reduce the cost of containment measures, they'll always be taken too late.
As the coronavirus spread throughout China, I watched in frustration as nations dragged their feet on implementing travel restrictions. (Sure, there are studies that say travel bans "don't work", at least not to stop pathogens 100%, but they certainly can slow their spread, buying time to respond. And if the rest of the world manages to avoid human-to-human spread of the coronavirus, it will be a clear indicator that travel bans and quarantines did work to constrain this virus.) The earlier and more aggressive the travel bans, the more likely they are to work. But authorities making these decisions are faced with a dilemma: if they act quickly and proactively, and this results in them successfully preventing a pandemic, people will only see the economic damage caused by the measures and will say they overreacted. If they act too late, the pandemic happens anyways, and people will say they acted too slowly.
Trapped between these unpleasant options, authorities only want to respond at the last possible minute, and only along with other nations so that they are not alone in taking an economic hit. The WHO's elevation of the coronavirus to a “global health emergency” on 1/30 seemed to serve as the Schelling point for countries uncertain about taking action. In the days that followed, multiple countries including the US announced travel restrictions. This demonstrates the importance of proactive leadership in getting localities to take action. We may be spared this time, but the same situation with a slightly different set of variables which are currently still unknown - rate of infectiousness, length of asymptomatic transmission period, higher mortality - could easily lead to a deadly crisis.
Currently, the costs of containment measures are simply too high for action to be taken in a timely manner. In the long run, we need to lower the costs of containment so it is not such a sacrifice to make these decisions.
Genetic engineering and Biowarfare
As if nature's war of microbes against humanity were not enough, fellow humans now have the ability to weaponize microbes as a new lethal and poorly understood technology of war. We don't know what an assault of offensively deployed microbes looks like, so we are ill-equipped to deal with it. Presumably it will look like a naturally occurring pandemic, but more strategically calibrated to inflict maximum social and economic chaos.
Thankfully, as far as we know, releasing a bioweapon among an enemy today is still as game theoretically pointless as dropping a nuclear bomb. The principle of MAD, mutually assured destruction, has prevented nuclear powers from starting hot wars with each other. Biowarfare has its own MAD as long as microbes do not discriminate among human hosts. Given the difficulty of constraining pandemics, there is a high probability that any microbe released among an enemy would make its way to the aggressor's homeland and decimate their populations as well.
However, there is a possibility that pathogens could be engineered to target different biological properties, or more dependably, humans could be immunized or engineered to be resistant to custom pathogens. The recent case of a Chinese scientist who used CRISPR-Cas9 to modify babies to be resistant to HIV points towards promising and perilous outcomes of future human engineering. As a species, we could deliberately patch up our vulnerabilities to ancient microbial adversaries. But as nations, this could conceivably be used to defend a domestic population from microbial adversaries that are later weaponized against others. World War Three will be a biological war, and the nation that wins will be the one that develops the best vaccines.
This is a horrifying realization, and I hope it never comes to pass, but it must be considered as a very real possibility of 21st century warfare. No amount of protesting, consciousness raising, or international cooperation was able to bring about multilateral nuclear disarmament despite the apocalyptic threat of thermonuclear war hanging over our heads. Likewise, if there is no biowarfare equivalent of MAD, I have little hope of international bans holding out indefinitely. All it takes is one country with the least scruples about experimenting on their domestic population and unleashing bioweapons upon an unsuspecting world, and all bets are off.
“Weakness and ignorance are not barriers to survival, but arrogance is” - Liu Cixin
The above quote is from The Three-Body Problem series, a gripping science fiction trilogy by a Chinese author that is highly relevant to considerations of existential risk at this point in time. It concerns humanity's struggle against alien invaders that are invisible yet omnipresent. This kind of struggle against a powerful yet invisible enemy that surrounds us has many parallels to our war against microbes. When it is still uncertain what our enemy is capable of, it is dangerous to be too self-congratulatory about our recent progress and assume we have defeated them once and for all.
We have known how to fight viruses for less than a century. These alien replicators, which can barely even be considered alive, precede our emergence on this earth by more than a billion years. While we and our societies have grown in complexity, they have remained ruthlessly streamlined, a few free strands of DNA or RNA seeking hosts. We assume that we are the pinnacle of intelligent life, that highly evolved complexity is adaptive and beautiful, and that we represent and are seeking further "progress", the purpose of evolution if there is one. We think and act like the top predators on this planet, capable of meeting any challenge except the ones created by the consequences of our own actions. But what if complex systems are really much more fragile than they appear, and in the long run the real apex predators turn out to be the simplest units, the lowest common denominators of replicating agents?
This is also a horrifying possibility to consider, which is why I'm sharing it with you, so I don't have to face the existential horror alone. I hope humanity and high tech civilization continues to thrive and eventually explores the cosmos. I am viscerally offended by the thought of mindless microbial soup defeating us. But there are still many ways we could fail and regress to simpler, more primitive states of being, and arrogance may prevent us from anticipating and averting these outcomes.
We have advanced technology, but are still stymied by collective coordination problems. Our societies are large and complex, but not resilient. The public has a lot of faith in a new science that has only succeeded in pushing back the assault of the microbes for a century or so, a blink of an eye in evolutionary time. The attitude that our public health authorities can deal with anything today is a form of arrogance that leads to complacency and underestimating the enemy. We would do well to have a bit more humility when it comes to microbes - they may yet turn out to be the apex predators that will inherit the earth long after they have consumed their human hosts. Evolution towards increasing levels of complexity is an ongoing experiment, and not a foregone conclusion. We cannot take progress or our current security for granted.
Once we recognize that global society is vulnerable to microbes of mass destruction, what can we do to mitigate the risk?
We can lower the economic cost of travel restrictions and quarantines. Decentralizing infrastructure and having fallbacks for remote work are measures that would make the economy less dependent on travel. With less risk of triggering economic collapse by starting a quarantine too early, authorities can make quicker decisions.
We can prepare individually and collectively for dealing with pandemics. We have faced existential risks before when the threat of nuclear war was prominent, and in times of war and crisis. Having response plans that include instructions like a social isolation policy would go farther than admonitions like “wash your hands." We hear the refrain of “wash your hands” because it is an individual and not a collective risk mitigation strategy. We are not capable of pulling off the more effective collective strategies without high costs.
And most basic of all, we can recognize the risks and work hard to ensure that progress and complex life continues. Progress is a Red Queen's race of keeping up with the consequences of our latest changes to the environment, and of the lethal adaptations of our parasitic predators to us. We move forward by staying one step ahead of disaster.
We should consider constructing critical infrastructure in such a way that it can be cut off from the rest of the world for weeks or months at a time with minimal disruption. Every region should have locally sourced options for the most essential things for survival - water, food, sanitation, and energy. When I visited Berlin, a friend showed me a hand-operated water pump on the sidewalk. In the event of a serious crisis that disrupted the water supply, this fallback source for fresh water would be indispensable to extending the lifeline of the city for weeks.
This could help prevent pandemics by making it easier to temporarily stop travel without strangling regions, but it would also help provide resilience in case of natural disasters and political turmoil. Fragile centralized systems either decentralize critical components proactively to create fallbacks in anticipation of risk, or undergo involuntary and catastrophic decentralization when they break apart.
Together, but Apart
Dangerous pathogens are mostly spread through physical proximity. In an era of robots, drones, and remote work, we don't really need to be in close physical proximity anymore for many kinds of work.
In the movie Contagion, about a global pandemic, a US government official discussing new quarantine measures says "Congress is figuring out how to work online". Ideally, Congress and many other institutions would figure out how to work online before a pandemic hits. In China right now, thermal imaging drones are currently being used to take people's temperatures without them having to leave their apartment building. When I went to an urgent care clinic last year, a nurse took my temperature and then pulled out an iPad which we used to communicate with the doctor. Why did I even need to leave the house then? You could imagine all these measures being combined to create a pandemic response plan that allows doctors to consult patients at home, drones to deliver sensors and medications, and critical institutions to continue working remotely.
As a society, figuring out how to work remote and having robots and drones perform crucial tasks and deliveries is a great fallback measure for when we still need to communicate and cooperate but cannot risk being near each other.
Biowarfare and Pandemic Preparedness
Having a general pandemic response plan that people know how to follow is a good starting point for a viable biowarfare defense strategy. During the Cold War, everyone from military officials to schoolchildren were drilled on how to respond to an imminent nuclear strike. Kids were taught to “duck and cover” under their desks. We may not have reached Cold War levels of anxiety about biowarfare threats yet, but having a more fully elaborated pandemic response plan beyond “wash your hands” disseminated by authorities would be helpful. (Although I suppose washing your hands in the midst of a full-fledged pandemic is about as helpful to survival as ducking under your desk during a direct nuclear strike.)
In the absence of forward-thinking policy, individuals aware of the risks can take steps to prepare themselves. Having the resources for a household to be self-sufficient for a few weeks at a time without having to venture out for supplies is a decentralization of infrastructure at the micro-level, which people can undertake voluntarily. The fewer people who have to leave their houses for supplies during a quarantine, the less likely it is that pathogens and social unrest will spread.
Don't take progress for granted
Every new technology opens up new possibilities, and also presents new risks. We have to race against ourselves to invent solutions to the problems created by our previous solutions. Modern travel has connected the world in marvelous ways, but it also makes us more vulnerable to global pandemics. Our enthusiastic overuse of antibiotics in the war against microbes is now creating antibiotic-resistant superbugs. Our attempts to modify ourselves to become immune to pathogens will also risk human genetic engineering or bioengineered pathogens getting out of hand and, either intentionally or unintentionally, killing millions. A realistic approach to the risks we now face does not involve either decrying or naively believing in progress that we do not have to work for. We can only continue to pursue knowledge and embrace the changes required to survive in the new environment we have created.
A quote from a computing pioneer:
“We have modified our environment so radically that we must now modify ourselves in order to exist in this new environment. We can no longer live in the old one. Progress imposes not only new possibilities for the future but new restrictions… The simple faith in progress is not a conviction belonging to strength, but one belonging to acquiescence and hence to weakness." - Norbert Weiner
We have successfully connected the world, and learned how to modify our biology. Now we must learn how to decouple from that interconnectivity when needed, and create backup plans for when bioengineering goes wrong.