COVID was not a failure of the system; it was an inevitability.

The COVID pandemic was way overdue.  It’s amazing it took this long. That isn’t a reference to COVID specifically, but that COVID and other pandemics are expected and have been expected for many years. And then we got one.  Yay for accurate predictions!

            The COVID pandemic is analogous to wildfires in California (and now the rest of the western states).  The current situation was predicted by Harold Biswell in the 1950s and 60s, and the fire patterns in California were described by Richard Minnich in 1983.  That is, if we put out all of the small fires as they occur, we create the conditions for large fires that we can’t control.  Biswell predicted that dry, windy conditions with high fuel loads would create a situation that was beyond our capacity to control. He died shortly after the first fire to demonstrate his predictions: the Oakland Fire (or Tunnel Fire) of 1991.

            In modern medicine, we have worked assiduously to put out each and every viral and bacterial fire that comes along. We developed numerous vaccines since about 1900 and that stopped a great many diseases and saved countless lives, mostly among children.  We have deployed huge quantities of  many antibiotics since 1945 and ushered in the medical era wherein we can stop almost any pathogen we encounter.

            However, we keep coming across worrying signs that we still don’t really have control and, worse, we really don’t understand viruses and how they interact with a world populated with nearly 8 billion people.  Perhaps the biggest red flag was HIV in 1980.  One of the great outcomes of HIV is that we are now a thousand times more knowledgeable about white blood cells than before HIV.  We understand how the body is reacting to the virus and how the virus is using our own cells against us. We have learned a huge number of amazing things about ourselves. We also haven’t solved HIV or developed a vaccine after 40 years.

            SARS (2002-2003) was another wake-up call. Like HIV, the spread of these new viruses can seem almost instantaneous because an infected individual can travel from one side of the globe to another in a day, can interact with hundreds of people on the way, and may be asymptomatic the entire time.  In contrast to HIV, SARS was highly communicable and we stopped its spread because of remarkably fast actions.  SARS has an Ro of ~1 (capable of producing an epidemic), but COVID-19 may be as high as 6. 

            However, what exactly have we learned from these earlier experiences?  As a culture, I would say next to nothing.  This pandemic has clearly demonstrated that most of us are in disease denial and governments are almost helpless to do anything about that. And a virus with Ro of >1 is very hard to stop and one with asymptomatic spread is essentially impossible to stop.

            Today we have almost 8 billion people living in crowded cities. In America, the urban population is more than 250 million (75%). In China, that number is 900 million; in both India and Europe, it’s 500 million. The WHO estimates almost 4 billion people live in urban and suburban areas.  Why are we surprised at disease outbreaks?

            There are about 90 cities in the world with 5 million or more inhabitants.  All of the factors that govern epidemic spread are met and exceeded in these places.  Large cities have many places for mass gatherings including sports, culture, recreation, marketplaces, and seasonal events. And the cities all have airports that connect them within hours of the entire world.  The potential for superspreader events exists daily.

            International travel is available to almost the entire population of the planet.  We do not screen for disease. We do not have a strict health declaration policy.  We did not require ppe in airports or on planes until COVID. We do not have the capacity for filtering air around individuals on planes.  We do not have the capacity for enforcing personal distance under normal conditions.  We live in a world that pretends disease is the exception, not the rule, and as a consequence have created the perfect conditions for epidemic spread.  And yet, although we know this, we seem to be surprised.

            Individually, prior to COVID, few people sneezed into their elbow, wore face masks, stayed home for a slight fever, paid much attention to a cough.  We worked and played even when we knew we might be fighting off some minor disease.  We were “troopers” and “warriors” and we were complemented for being tough and stoic.  It showed “leadership” and a “can-do attitude.”  And most of us can’t wait to get back to a situation where all of that is true again. 

            The fact that we have not had devastating pandemics within the lifetime of anyone currently living is a testament to medical technology and the watchfulness of government and private entities, such as WHO and the CDC.  Their failure in the case of the COVID pandemic is not a failure of the system, it is an inevitable result of population growth and concentration.  It reflects the human effect on the environment, it reflects how our food is produced, and it is an outcome of the unrelenting pressure we have put on the resource base that supports us.

            And unfortunately, it is also a demonstration of the predictions made by Garrett Hardin in 1968 (The Tragedy of the Commons) about what happens to commonly owned spaces and resources when we fail to enact protections against human selfishness.  Unfortunately, western societies are about to find out the hard way that social restrictions are either going to be a way of life for us going forward… or else, we can continue to ignore natural laws and fall prey to natural selection for stupidity.  The latter choice is the path chosen by anti-vaxxers who live by the highly respected tenet that one should die in defense of one’s philosophy. Even if it’s the philosophy of ignorance.

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