“ The poster expands on his claim in the video, in which he plays a clip of Goodall’s remarks, then cuts in to ask:
"What was the population in the year 1500? About 500 million. What on earth could take place that would cause a planet with 9 billion people on it to be reduced by 95% to 500 million? Hmmm…I wonder if a virus could do that?"”
Is there a companion piece coming up that looks at reforming our public health agencies and improving their ability to adequately respond to new pandemics? That seems like a big part of being prepared for the next big one.
Also, what does good preparedness look like at the local or state level? Let’s say I’m the mayor of Orlando and my public health department has been doing wastewater monitoring and they tell me a scary new disease is detected. What should I do? What’s the response plan?
That's an idea. Have one institution focused only on diseases with externalities -- I get Corvid and I can give it to someone else -- and another focused on diseases where outside intervention is a public good -- it costs little more to inform everyone to avoid contaminated lettuce from source Y than to inform only on person. Whether they really should be separate institutions may depend on possible complementarity in the inputs (outreach? data gathering?) into carrying out the two different missions.
I feel like this may be a midwit take, but my initial reaction is that it might be good to create a Pandemic Prevention Agency in the federal government. Not just an office in the White House like the one Trump shut down, but an actual agency as big as CDC with career staff. I'm not exactly what kind of powers it should have, but it seems like CDC (its peculiar bureaucratic failings aside) has a different mission than the kind of stuff necessary to respond to pandemics.
What is the mission of the CDC though? And how would yet another agency not fall prey to the same bureaucratic failings? The real problem revealed by the response to Covid in the US is that many Americans don’t trust public health expertise or the federal government. Another federal public health agency isn’t going to change that.
I still remain confused why Everybody Knows ventilation is the greatest thing since sliced idiom, but in practice it's gotten implemented...not much at all? Or even just maintaining/repairing already-existing HVAC systems. Even outside of covid, I've heard so many positive cost-benefit things about reducing indoor air pollution and increasing oxygen levels that it sure feels like a low-hanging $20 fruit lying on the ground. Why don't we do more of this? Unlike pan-vaccines, it doesn't even require new science or enormous financial resources..."Gentlemen, we have the capability!"
Separately, it'll be kind of sad if factory farming ends because all the animals got killed by avoidable diseases before we could reform the system intentionally. I hope it's even possible to go back to traditional agriculture, if such a fate befalls our livestock.
Improved ventilation *does* take huge amounts of resources. You can change building codes to make future buildings have better airflow (though you’ll have to argue a lot with the fire department about how this interacts with fire safety) but for existing buildings there’s not all that much you can do. You can replace all the expensive equipment that runs the HVAC, but that’s only going to help a little. It’s not like you can go through every single building built in the last 30 years and add openable windows, more outside air sources, etc.
Does it take huge amounts of resources though? Sure, moving from MERV 8 to MERV 13 filtration might require stronger blowers, but it does greatly decrease PM concentrations of the size that carries COVID _and_ is a regular improvement homeowners can opt for when purchasing HVAC. https://www.epa.gov/indoor-air-quality-iaq/what-merv-rating
Or hell, an elementary school can put $200 HEPA filters in each room of a school for ~$10k. Considering the windfalls states received lately from feds, this doesn't feel crazy on a per-school basis.
If that's really sufficient, then maybe this isn't as big as I think. I was assuming that you actually need to increase air flow though in a lot of the modern buildings that have drastically reduced air flow for fire code and energy standards. And that would mean actually creating more physical openings.
Would love to hear from HVAC / AQ experts on how hard it is to increase the turnover rate (air exchanges / hr) and to what level for maintaining low % of PM size that carries viruses. In a school, say.
You’re likely right that it’s not just a filter thing but also a turnover issue too.
Because (almost) no one really believes the benefits are worth the costs.
And, more immediately, if you increase the fresh air flow in a modern commercial office building, the building is instantly worth less. [More fresh air = higher HVAC costs = lower operating margin - commercial office properties are priced on multiples of projected earnings.]
Is that so? I suppose I got suckered, then...that blows. Every once in awhile these sorts of Simple Uncontroversial Solutions crop up and it seems like an easy win-win-win, but I guess I should know better by now than to assume the veracity of such narratives. "If it were that easy/good, we would have done it already," says Econ 101. (Yes, I know, all theoretical models are wrong, but some are useful...)
Slow Boring always makes me *want* to believe this isn't a null possibility-space, though. That's the quixotic quest-vibe here. Although the same logic applies - the fact that Matt still has a job writing this particular beat demonstrates that things aren't that simple, often. It's sure tempting to wish they were, though. What a nicer world that would be.
I actually think that this post is a smidge misleading in focusing on bioterrorism. Studying pandemics and teaching public health has convinced me that the major threat most Americans fail to think about is the growth of megacities in sub/tropical waterfront zones in less wealthy countries. (If you are curious about my work, including the hilariously on-point museum exhibit I did in November 2019 on the historical experience of pandemics, check out my website.)
Regardless of whether you think Covid was a lab leak, its emergence in a Wuhan wet market perfectly fits this set of circumstances:
1) Wuhan is a "new" megacity (i.e. more than 10 million residents, explosive growth in the last 50 years), which means that many residents are first- or second-generation city dwellers with deep continuing ties to other places.
2) Like most of the newer megacities, it has a relatively less affluent population, which is one reason--though not the only one--why it has a huge wet market.
3) It is unusual for being inland, but it is still constructed in a historic wetland, on the Yangtze.
4) Wuhan is well-connected to the global market / production system.
I will not go long on the specifics, except to say that this is a more or less perfect set of circumstances for nurturing new infectious disease outbreaks. Some of the factors are probably obvious to everyone who reads this (density, population, etc.), but some you might not be thinking about. Just to name two, wetlands and warmer areas are more conducive to both pathogens and vectors (like mosquitoes), and cities with high percentages of first- and second-generation rural-to-urban migrants experience constant flows in and out because of internal travel (go back to the village to visit family), which means you basically have a much higher flow of humans across different immunological / disease zones.
Bottom line is that I worry a lot less about bioterrorism than about old-school novel infectious disease outbreaks, whether they are species jumpers, mutants of existing pathogens, or lab leaks. And I worry a lot about those. We have lived through a bunch of either actual or potential events already in just my lifetime--HIV, ebola, SARS, MERS, flu, Covid, zika, monkeypox, resurgent resistant strains of TB and gonorrhea--although most of them went unnoticed because they did not end up being a big deal or haven't become a big deal yet (i.e. the last flu pandemic was a relatively mild strain). But the truth is that we are getting hit on the regular. A Covid style event was just a matter of time, and the same is probably true of something worse.
I suspect that bioterrorism is harder than we suppose. Life forms are very complicated. You may think you have engineered the most awesome virus or bacteria in the lab but that doesn't guarantee that dumping it in the reservoir or spraying an aerosol in a crowded train station will lead to vast numbers of people dying.
Of course, even a very limited "success" would be very scary.
It's at https://www.jeffreycwomack.com. The exhibit was called "Going Viral"; you can see our official poster, including the now-hilarious November 2019 launch date, on the aqua colored block on my work page. There is a link within that goes to the tattered remains of the exhibit, but it's not much to see at this point, which makes me sad. But you can also find some stuff from the early pandemic on my blog page.
The tragic story of the exhibit is that it was conceived as a counterpoint / closing piece to the museum's exhibit on the 1918 flu pandemic, which launched that same fall (maybe the same month?). That exhibit, "Spit Spreads Death," was really heavy on digital interaction, with a bunch of touch-screen computer displays that let you do cool stuff like zoom in on particular blocks of Philly to see who died in your home during the flu pandemic. My exhibit was therefore designed as a totally non-electronic display with a heavy physical interaction component, as kind of a counterpoint palate cleanser to all the screens.
It was a three-part setup that basically walked you through historical ideas about infection before winding up in the modern era, with germ theory, and it paired the theories with particular diseases and epidemic events. In each section, we had sensory experiences paired with the images and text to help the participant imagine themselves in an epidemic event, trying to understand that event with the prevalent theories of the time. My favorite was cholera, where we had set up this little area as a mock-up urban alleyway, with sewer covers and windows and the like with smelly sachet bags; the idea was that you could replicate that famous Puck image of the health inspectors and go looking for the miasmatic smells causing the outbreak.
The final section concluded with germ theory, starting with Lister (the museum has one of his carbolic acid sprayers) and going through measles, which as you may remember had caused some outbreaks in low-vax communities in the summer and fall of 2019, including most famously the Disneyland and New York episodes. We did a lot of stuff that I am proud to say held up really well in the pandemic. We had a great section helping patrons see the interesting parallels between the old Plague Doctor costume and the stuff worn by modern medical professionals in high-risk situations like outbreak response (the bunny suit) and in surgical theaters (mask, gloves, eye protection, etc.).
In keeping with my own work in public health, we also had some fun material on hand and respiratory hygiene and vaccination. We put in this great mini-mock-up of a SEPTA bench and a lenticular--one of those things where it shows a different image from different angles--where you could see first a cartoon image of people riding a subway car, then an image of the same scene, but with points of contamination / germ contact highlighted in green (i.e. the air in front of a coughing child). It was a great exhibit, and I think everything held up really well to the actual experience of a pandemic.
Then Covid hit, and when the museum reopened, well, you can guess how excited people were about an exhibit where you walk around imagining yourself in a pandemic and interacting with exhibits that you were supposed to touch and smell. Heavy sigh. It was supposed to run until 2022 or '23, but instead they quietly pulled the whole thing down shortly after the museum reopened. It was a real bummer; we had spent a year and a non-negligible budget on all those interactive displays (building stuff strong enough for patrons to interact without having it break is surprisingly expensive because it has to be really robust down to little details). They left a little website up, which is linked on my site, but it's mostly just a bunch of teaser text.
This sounds amazing! Is there any chance you could persuade the museum to get it back up next year, maybe with an appendix about covid? Or are all the physical objects now gone?
I honestly don't know what happened to them. There was a great Plague Doctor mask mockup that someone walked away with, and I wish that someone had been me. It's probably just in storage.
But what was the population in those periods? Any idea? As far as I know, no city crossed the ten million mark (the modern definition of a "megacity") until the 20th century, and I'm pretty sure that Wuhan crossed it only in the post-WW2 period. But, hey, I'm happy to be wrong about that.
This is what I mean by "new," and it is specifically why I put quotation marks around the word. Wuhan is obviously not a new city, but it has a large population of residents who are relatively new, by which I mean one to two generations deep living in the city. That matters because, as I said, people in the first and second generation are much more likely to still be cycling back and forth to the countryside, because they still have family living out there or similar reasons to return. These internal movements are a significant source of pathogens moving into and out of cities that have experienced recent growth (and by "recent," I mean post-1950).
To give another example, I grew up in Houston, and I was the second generation born there; my dad's parents had moved from rural east Texas to Houston to work in the oil refineries. As a result, they still had family and some land in East Texas. Dad, as a kid, spent every weekend in a little town called Crockett. I, as a kid, spent much less time there, but we still went there 10-20 times a year, in part because Dad's dad spent an increasing amount of time there post-retirement. We did a lot of outdoors activity there. As a result, I was at much higher risk for, say, lyme disease exposure than you would expect for someone living in a white-collar upper-middle-class suburb of Houston. That is much less true of my son, who has been to Crockett maybe three times in his whole life. When he visits his grandparents, he goes to a suburb of Houston, rather than to the property in Crockett.
Does that make sense? It's not the newness of the city. It's the newness of the residents, as described by population growth patterns.
Wuhan has been heavily populated *by contemporary standards* since the Han Dynasty.
But for the majority of the Qing Dynasty the combined populations of Hankou, Hanyang, and Wuchang hovered in the 1 million range, and their links to hinterlands in places like Southwestern China were nonexistent.
Wuhan is pretty marginal in terms of bats; the local livestock populations are mostly chicken, ducks, and pigs, so the same illnesses affect it as do Raleigh, NC, lol.
It was very much a matter of blind chance that COVID broke out into a form which could easily spread between humans there as opposed to any of Chongqing, Chengdu, Guiyang, Kunming, Changsha, or Nanning, around which the relevant bat populations are actually located.
Could just as easily have been Xiamen, Beijing, or Shanghai as Wuhan.
Or, again, someone was selling "used" animals out the backdoor of the WIV. It's not the most likely zoonotic route but it cannot be ruled out because the Party won't fucking gather the data.
I mean, yes. That's the point. It could definitely have just as easily happened in those megacities or in many of the other, non-China megacities that have grown up in the last 50 years.
What I wrote is that modern megacities are particularly problematic centers for the outbreak of epidemic disease because of common qualities that differentiate them from the smaller cities with which most Americans are accustomed. What, precisely, are you arguing with me about? I get the you misunderstood my usage of the word "new"; is that what is bothering you? I don't think you actually disagree with me that Wuhan did not have ten million residents a hundred years ago. I think you agree that is a relatively novel development because...it is.
Like, precisely what statement from my comment that you think is wrong, and why did you go off on bats, a thing that I did not mention, almost as though...I knew better than that? I'm genuinely curious, because if I'm screwing up something in the public health literature that I teach, I should fix that misunderstanding. But right now I can't figure out what you are getting at, which leads me to believe that there's a misunderstanding.
I mean, honestly I was confused about the whole thing. It's the end of the quarter and I'm pulling some late nights right now on account of working three jobs this summer (long story, bad choice, will endeavor not to repeat), so I'm probably just being brain-fogged. It's why I wrote that last paragraph.
"The main reason I’m skeptical of the Covid-19 lab leak skeptics is that they seem to treat the idea of a lab leak as inherently improbable."
"That being said, I don’t particularly want to rehash the Covid-19 origin story because I think it’s become counterproductive."
Ooooooh, so close to admitting that the evidence points in the other direction!
But in all seriousness, I think your first statement is wrong. It's not that most lab leak skeptics treat that hypothesis as improbable (on the contrary, it very much is something we should worry about, as you nicely lay out today). It's that it's always seemed far more likely to be a zoonotic origin, and the evidence for the lab leak doesn't amount to anything more than "there's a virology research institute in Wuhan and the Chinese government is untrustworthy." Which, to be fair, is not nothing, but the onus really should be on the lab leak proponents to build a better case for it. Meanwhile, the zoonotic hypothesis has been carefully and thoroughly investigated (see https://www.science.org/doi/10.1126/science.abp8715, and Derek Lowe for further commentary: https://www.science.org/content/blog-post/origins-pandemic---under-rug). But as you rightly state, we need to worry about zoonotic origins as well! So I'm not sure why we can't just say "accidental lab leaks are possible and have nearly happened before, even if not in this particular case."
The problem with all of this is that the virus is *obviously* zoonotic in origin, and *obviously* had its first major superspreader event at Huanan.
The question, which is basically unknowable given the complete and utter obfuscation the Party is engaging in, is how the hell an initially bat-borne coronavirus almost certainly originating in Yunnan or Guizhou came to be in that market.
There is the obvious possibility: someone brought animals raised or captured in that region to Wuhan for sale. The chances are obviously astronomically small that any given civet, pangolin, or racoon dog from SW China would already have the virus but if you sell enough of them nationwide, it becomes an inevitability.
There is also the other obvious possibility, that certain people motivated by entirely non-scientific factors feel the overwhelming need to deny: The laboratory whose main reason for existence is the study of animal-borne viruses, especially bat-borne ones from SW China, located infected animals in its extensive surveying of the region, brought them back for study, and "misplaced" a few that ended up at Huanan.
The reality is that we'll never, ever know. And, and I feel the need to state this again, the CCP clearly and obviously does not regard the latter as an impossibility or even an unlikely cause, because they immediately stonewalled the hell out of all investigation that could rule it out.
They themselves suffer from immense GIGO problems at the local level, and if someone fucked up in this manner you can be sure that a lot of data and records are missing or edited to cover for it, such that the echelons of the Party responsible for working with the WHO just can't be certain something embarrassing won't bite them on the ass if they were to allow a genuine investigation.
I wouldn't be surprised if the virus was circulating outside of Hubei for months, slowly, but acquired greater transmissibility (ie, a new variant arose) in Wuhan, perhaps because of a more ideal environment for transmission (greater population densities, or maybe it was simply the first city where an infected animal showed up at a wet market?). If it hadn't been Wuhan first maybe it would've been Chongqing or Changsha or wherever.
Without a doubt you're correct the Party doesn't regard the lab leak hypothesis as an impossibility (nobody should), but I'm not sure the "stonewalling" says much either way. I believe it's entirely possible there are secrets not related to Covid they want kept hidden, and they're just nervous. I also think the specter of pushy outsiders just rankles the fuck out of them. My sense is they've become awfully prickly and thin skinned about outside forces and influences in recent years—forces and influences they regard as malevolent. In a word, they're arrogant, paranoid xenophobes.
I don't entirely disagree, but I think you're overstating the case that the sole driver of their behavior is a sneering inferiority complex. That's definitely *one* of the drivers, but in this case I think the Party itself isn't completely sure what the hell happened and is making certain the muddy the waters as much as possible.
EDIT: Also, just to be completely clear, when I say "misplaced" above, what I mean is "I have worked in Chinese labs and the lower level employees are poorly paid and treated like shit, so many things with black market sale value go missing. A 'used' pangolin or civet could absolutely be among those things."
Yeah. I thought he was off on that statement, too. Labs leaks have indeed occurred, and absolutely cannot be ruled out in the case of Covid, but one thing the zoonotic spillover hypothesis has going for it is it's simply a vastly more *common* cause of pandemics than lab leaks. Pandemics have been around a lot longer than laboratories. Occam's razor.
I don’t think you can use the pre-1950 history as relevant evidence. You have to compare frequency of the two types of outbreaks in circumstances like the present. I think the balance still tilts in favor of wild zoonosis, but not as strongly as it does if you weigh all those decades and centuries when labs couldn’t leak.
Fair point. And lab leaks have indeed occurred. And indeed resulted in deaths (a leak of the SARS virus by a lab in Beijing resulted in a death in 2004, for instance). Still, have any *epidemics* resulted from lab leaks? I haven't been able to find an example. And again, we know natural zoonotic spillover has been a frequent, dreaded stalker of our species throughout its existence. That's not to say the Covid19 pandemic didn't result from a laboratory link in China. It's a plausible theory that cannot be ruled out yet. I do think the frequency with which zoonotic spillover has plagued (literally) homo sapiens is a vote in favor of this as an explanation, and from what I can parse via my limited layperson's capacities, this seems to be where the bulk of science community opinion currently resides.
But would it shock me if revelations at some point came to light suggesting compelling evidence that Covid was leaked by a Wuhan lab? Nope, not in the least.
I would agree that the onus of proof is on the lab leak proponents, were it not for the fact that the Chinese government is not at all collaborating with external investigators.
Throughout the history of investigation, destroying/hiding evidence, as our “partners” did, has been seen as indicative of guilt. People who aren’t guilty of anything shouldn’t behave as if they are.
We’ll probably never know, but some key actors were behaving as if they had something to hide. It’s human nature, not nutty conspiratorial thinking, to wonder why innocent people would behave that way.
To be fair, the Chinese government is *especially* prone to acting guilty even when it isn't. And Saddam Hussein did the same thing when he refused to let the weapons inspectors in.
Thought experiment - What if we knew this was a lab leak? What are the scientific and political implications? They seem pretty enormous. It turns into a Marvel movie where the people who saved us are the ones who caused the problem in the first place.
Matt’s post is a cri du coure for serenity. We are all going to die. We are much less likely to die in the next year than our pleistocene ancestors, our medieval european ancestors, our early industrial ancestors, or even Americans 50 years ago. Of course, our minds are really good at imagining ways we could die— asteroid risk, climate change, nuclear war, bioterrorism. Yet these exotic risks have killed very few people. It’s easy to imagine mass casualty scenarios precisely because we lack robust data on how these things kill people.
If I want to live longer, my best strategy is to eat fewer calories and less saturated fat and drink less alcohol. That strategy has proven results as obesity, clogged arteries and booze combine to kill millions of Americans every year. I should probably stay married, which also has proven longevity benefits. Controlling my appetites and maintaining my marriage are hard enough, and would be harder still if I walked around freaking out about AI risk.
“Honey, could you fix us a salad?”.
“No baby, I need to understand AI risk, why don’t you order pizza.”
“I wish you loved me enough to make healthy food.”
“It’s hard to focus on that when the world sucks so much.”
(queue the cork screw and possibly the divorce lawyers).
Throwing out actual risk of dying, you don’t have to go back very far to see that even with a virus much more safe than what Matt is writing about in this post likely caused a ton of harm to your specific life.
I didn’t much enjoy the state of the world in 2020. You don’t have to walk around every day terrified of the world ending, but advocating for better responses to the next virus seems fairly logical if you don’t want another large part of your life spent locked down or arguing about that etc… even if you’re not worried about any risk of dying.
I can’t actually tell what topic that Matt writes about would interest you if you’re not at least somewhat interested in how to prevent that situation again - “I don’t think it’s worth talking about how to improve zoning laws to impose my or others lives because it goes against serenity”.
If you feel like that straw mans what you’re saying, what are the consequences of what you’re saying? Matt’s post seems pretty straight forward of “let’s do some things that seem like it could help”. It’s not hysteric about existential risk really. Do you think we shouldn’t enact better pandemic response items?
We agree that 2020 sucked. We probably disagree on how it could have sucked less.
We were very far from crushing the curve, even the iron fist of the Communist Party of China could not contain the virus, nor have they figured out how to crush the curve after almost three years.
Serenity was a better option. On an individual level, serenity would have involved:
1) healthy young and middle-aged workers understanding that their individual risk was low and that their duty to society was to carry on with their jobs and develop a cadre of naturally immune workers
2) some courageous octogenerarians deciding that a 1% risk that a family Christmas would kill them was worth taking when they only had a few Christmases left
3) heroic young volunteers doing challenge trials-- an act far safer and just as noble as storming the beaches at Normandy
4) a calm acceptance that a dying to do one's job or to love one's family is a more beautiful death than 90% of Americans experience today; and
5) targeted efforts to help vulnerable, high value workers (eg 60-year-old teachers or judges) work remotely, while the less vulnerable took the physical risks of maintaining order in the classroom or court.
Ehh. This is a fantasy just as much as the "we should have locked down everything until the virus went away" is a fantasy. People's behavior was always going to change in response to COVID, even if the government didn't mandate or support it.
"Keep Calm and Carry On" would have simply lead to a lot of people suffering more ancillary consequences and the economy suffering badly. Note how quickly Britain's initial policy of "isolate the olds and let the young people all catch it" fell apart under popular pressure.
Given the speed of spread, deaths, and complete lack of effective treatments in the first 3-4 months, it's also a perfect way to scar everyone so badly that 30% of the population is still playing "COVID Warrior" in 2022 instead of 5%.
I mean... ok? I disagree, but if that's how you want to play it, then I'll up the statement: this is a fantasy that was completely impossible from day one as it ignores the basic human condition.
There are plenty of ways that events might have played out starting from January 2020, your vision is NOT one of them.
Perhaps to surprise you, I don’t actually really disagree that strongly with much of this. I particularly agree with 3 and 5, generally with 2, and would need more info about what you mean by 1 and 4.
That said, it doesn’t really answer my prompt. That’s what your lifeview of serenity would’ve advocated for in 2020. Right now, it appears your lifeview of serenity advocates for not doing any work to help prepare for an eventual future disease? The lifeview appears to be “don’t prepare for future bad possibilities, and then when they come, accept they came with the lack of preparations we’ve done with serenity”
'...develop a cadre of naturally immune workers...."
There is no natural immunity to COVID-19. People get reinfected twice, 3 times, 5 times. Getting it once does not protect you, or protect others from being infected by you on a later reinfection.
We did not know that two years ago. We know it now. "Herd immunity" might have worked with a different virus. It never would have worked with COVID-19.
I think we know there *is* natural immunity but that “immunity” doesn’t mean “100% safe”. Even the unvaccinated are getting milder cases now, because they’ve mostly been infected before, and their bodies are developing better responses.
And with classic COVID, both wild immunity and vaccine immunity seems like it was a lot stronger than with delta or omicron.
Right. If you look at US death numbers of late (assuming they're reasonably accurate) it's hard not to conclude the utter endemicity of the virus in the States (and thus the near universality of antibodies in the populace) is protecting the country from excess morality at present.
Ehh, the transition from "occasionally deadly and always miserable" to "common cold" seems to be mediated by the *long-term* immune response triggered by multiple infections.
It's unknowable but the way to bet is that if we plopped a common cold coronavirus down in a large population with no historic exposure it'd do damned near exactly what COVID has.
In which case, the role of vaccines is to make that transition less deadly by beefing up the mechanisms of short-term immunity even if it's non-durable.
We really, really need population surveillance testing for the four common cold coronaviruses so we can finally understand things like asymptomatic infection rates and contagiousness in long-term endemic coronaviruses. Until we know what the endgame looks like we have no idea how near or far we are today.
I would have more respect for Matt’s post if he 1) said explicitly what proportion of gdp he wants to devote to mitigating long term risks and 2) explained what valuable activities we should do less of to invest in asteroid prevention, etc.
I think he thinks we have already invested enough in asteroid prevention. He’s asking a few billion a year for pandemic prevention - about 0.01% of gdp.
I don’t think his christmas list could be achieved for that budget. but if it could, 1) sure 2) thr interesting thing is his mental focus on how 0.01% of gdp should be spent
Why set up these things as tradeoffs? You can eat salads AND have a few cents of your tax bill go to subsidizing better ventilation and vaccine preparedness. They pass good cost-benefit tests even for pandemics LESS infectious/deadly than COVID, the PHE just does not think in cost-benefit terms.
It’s naive to think that individuals have infinite energy/time/bandwidth to devote to good health. Every minute I spend working out is a minute I don’t spend working. Every drink I don’t have with friends is an immediate pleasure forgone.
Very few people—even doctors— have medically optimal lifestyles. There are other, competing goods and we have to choose. Every minute spent thinking deeply about AI risk was not spent doing other things.
This seems nonsensical in that I don't think anyone expects that individuals have infinite energy/time/bandwidth. Thankfully, we're an advanced economy capable of excellent specialization. In this case, what we are advocating for is a general recognition that its an issue, an allocation of a small but impactful amount of resources to a small group of people to work on. This would enable us to be better prepared should future incidents occur.
This is no different from what we should be doing from a hundred (thousand?) different issues. We're a rich society! Really, really rich! We could spend .0001% of our GDP on this and wouldn't even notice it, but it might save millions of lives and a trillions of dollars in economic impact.
Granted everything has an opportunity cost, (I sort of skimped on my morning exercise today becasue I was especially interested in this SB topic :)) but I still don't get posing healthful living as a particular trade off with thinking about societal level problems.
I can understand a strong anti-hysteria stance. I don't think I understand this, which I read as a strong anti-caring/anti-prevention stance. What is the argument against *simply wanting some measure of preparation and contingency planning*?
What if the wife says "could you fix us a salad?" and the husband responds that we already live longer than our ancestors so the wife needs to learn serenity—that her attention would be better spent on keeping their marriage healthy, meaning not stressing him out with all of her focus on obesity and clogged arteries? That seems just as reasonable as your approach here.
“The main reason I’m skeptical of the Covid-19 lab leak skeptics is that they seem to treat the idea of a lab leak as inherently improbable.” This statement strikes me as weasely imprecise and only correct (or “fair,” since it’s a “seems” statement) if you cherry-pick your skeptics or skeptical claims. Most prominent lab-leak skeptics I’ve read readily acknowledge the absolutely essential need for great care in lab settings because of the real risks—many seriously entertained (and subsequently investigated) the possibility. If “inherently improbable” is supposed to describe their estimation of the likelihood that “some lab leak of some disease happens sometime,” then I don’t think that fairly describes their view. Nor is it improbable that “someone wins the lottery.” But the likelihood of any one person winning the lottery is improbable, and so is the likelihood of any particular instance of a lab leak. For Covid, the fact that it emerged near a lab significantly raised that low baseline probability, but no one’s found evidence of any of the additional markers we would expect to find if there was a lab leak.
Does it matter for how much to subsidize ventilation/UV systems and get vaccines ready for use within weeks whether the pathogen arises from a crossover, lab leak or bio-terrorist?
This post is all over the place and in some spots nonsensical. I've been tangentially associated with the bioweapons community during my working career (consultant to the former Congressional Office of Technology Assessment as well as to the Dept. of State prior to the 3rd Review Conference on the Biological Weapons Convention and a participant in Federation of American Scientists' work group on this issue). Anything associated with high dread worries the public as Paul Slovic's seminal work in the late 1970s demonstrated.
Microorganisms mutate all the time (thank you Charles Darwin) and this has been a fact of life for centuries. Pandemics come and go (Black Plague, 1918-19 influenza, and 1957 Asian Flu, etc). The failed response to Covid-19 is multi-factorial and books have and will be written about this. All we can request of policy makers is to use common sense, prepare, and react.
Yes, we do need more antibiotics but recognize that the easy work of natural product screening has already been done and new approaches are required. However, recognize that most illness and fatalities arising from the bacterial infections shown in the table are more a function of the individual's health (malnourishment, immunocompromised, etc.).
If Matt set out to scare his readership, I guess he achieved that goal. He didn't scare me.
Do you disagree with the conclusion - basically “things could get a lot worse”, and “we could do a lot to prevent that from happening?”
Get worse: this seems fairly obvious. We learned that we’re entirely unable to prevent the spread of a highly contagious virus. Is it not possible that something as contagious as COVID but, say, 5x more deadly will appear in the next 25 years? Are the bio weapon concerns Matt raises not possible?
Prevent that: Do you disagree with anything in the last paragraph? Any reason not to advocate for, at least, most of it? In my view, US public health is way too invested in communication and public behavior (which I think we’ve learned is pushing on a rope), and not invested enough in some of the infrastructure Matt mentions here. Do you disagree?
the creation of bioweapons is quite challenging and delivery is even more complex. the only exception is the use of specific toxins to kill an individual (which has been done several times in recent history, usually with ricin). I don't lose any sleep worrying about bioweapons.
I'll not get into the COVID prevention as I spent the first eight months of the pandemic putting out a daily newsletter that dealt with all aspects of prevention, treatment and remediation (if you are interested, you can google my name and COVID-19 Resources; all the newsletters are archived there). Had people used well fitting masks (lots of data on this!) in the early days of the pandemic, the trajectory in the US would be quite different. Public behavior, which was horrible in this country (vaccine deniers etc) and is hard to change.
There will always be new pathogens arising whether it is a novel microbe that jumped species or an existing one that mutates. Improved vaccine development is a key tool here (though most people don't realize that a lot of this including mRNA vaccines was worked on during the Zika outbreak several years ago.
I could write lots more but it's all on my website.
I think many of the things in the solutions section are good ideas for general pandemic response though I am skeptical of some of them (like putting UV lights everywhere).
I don't want to put words in Alan's mouth but the essay seemed all over there place and nonsensical to me because the call to action (pretty generic preparedness) seems totally divorced from the hook (hypothetical bioterrorists can easily design incredibly specific pathogens). I think the idea that this imagined bioterrorist built up in the middle of the essay can create super advanced eluding pathogens but is going to be defeated by better monitoring and better masks is pretty weak.
Very little as the compound in them is unrelated to all the medicinal antibiotics. Jeff Rigsby's comment about antibiotics in animal feed is the critical one.
Yep, 'tis a mystery why the infrastructure bill did not include money for ventilation/UV sterilization and universal vaccines or even just a bunch of MNR single strain vaccines for different families that could be tweaked for whichever strain of virus family Y turns up.
But in a way it's just part of the same mystery as to why these things were not done FOR COVID! [Hint it's more the fault of the PHE [Public Health Establishment than Donald Trump.]
The American Rescue Plan included plenty of money for the states that they were *supposed* to spend on ventilation for schools and such. Didn't really happen.
"Supposed to" or "could have?" And of course the availability of money presumes that school districts were already making deductions about which schools to close and not, which restaurants to allow to have indoor dining or not taking account of the ventilation. I did not mean to imply that the only thing missing from a proper COVID response was appropriation of funds by Congress.
"supposed to have" in that Congress and Biden highlighted ventilation as a main use case, but the actual language was pretty vague and states/cities/school districts could often do anything related to education. Bit of a mess tbh. It looks like some places (LA; Boston; Durham, NC; St Joseph, MO) went all in on ventilation and filtration and others just... didn't
Yeah ventilation is pretty straightforward and not particularly controversial. It has plenty of non-Covid benefits. But it’s not something you see. I suspect that is a big reason public health decided to spend its time fighting for elementary school mask mandates in the 2021-2022 school year instead of improving ventilation. The irony is that improved ventilation would probably have had a big benefit for the low income kids they claimed to be prioritizing.
They wanted to be "seen and not heard?" But even if that is right, why that "decision" (quotes becasue things happen more by inertia than by "decisions.")
There’s actually also a Tom Clancy novel about this idea (Executive Orders) where Ebola is weaponized and spread at a business conference. I believe President Jack Ryan ends up enforcing a nationwide lockdown (the national guard literally prevents people from crossing state lines) lol
Ebola was my favorite disease to be scared about in Jr. High because of the excellent film “Outbreak” with a peak 90’s Dustin Hoffman chasing a monkey, solving a virus threat and yelling at people in all the most satisfying ways.
I liked One Billion Americans a lot but today's post raises all sorts of issues against a larger world population (unless, perhaps, we go vegetarian on a large scale).
Concentrated agriculture just asks for this type of accidents. Some people (eg https://ourworldindata.org/mammals but estimates vary a bit, apparently) believe that mammal bio mass is currently 35% human, 63% livestock and 2% wild mammals (23%, 60%, 17% in 1900, respectively) and with a substantially larger world population, this is unlikely to improve.
I (and presumably Matt) just wants more of the world's population -- the most skilled/talented/entrepreneurial ones -- working in the US. The Idea is not One Hundred Billion Earthlings.
Sure. But a bigger issue that MY doesn't grapple with in this column is that arguably the entire concept of national competition that is embedded in your comment, and in One Billion Americans, and really in the entire post-Westphalia concept of the nation state, may be *the biggest problem* in solving the issues the article raises. After all, for all that Bin Laden demonstrated that a handful of real dickheads can do a huge amount of damage, the biggest risk in biosecurity comes from state competition, whether in the form of warfare or (much more likely) accidents from labs and scientists who are working on projects that are fundamentally about state competition and advantage.
Now, the inevitable retort to this is of course that political reality needs to be acknowledged, and that neither the extreme of abolishing nation states nor even the milder form of increased gloabal cooperation seem particularly realistic right now. But then again political reality is also why this stuff gets basically no traction in Washington as well.
One Billion Americans does not depend on geopolitical competition. We US-ians would be better off if we applied cost benefit considerations to who and how many immigrants we admitted. It's a nice side effect that widespread use of cost benefit analysis would increase the geopolitical weight of the US vis a vis countries with even worse political systems.
The comment doesn't make logical sense? If you are 'applying cost benefit considerations to who . . . you admit' then you are choosing who you want, which is to say you are in a competition (with other countries, ie geopolitical competition) for talent.
I agree that there is or could be a "competition" for global talent, but that need not be the motivation for choosing immigrants that optimize US well being (w/o counting plus or minus relative geopolitical weight). I agree that if we include geopolitical wight in the calculation, the optimal rate of immigration would go up, but the two considerations are separate. [Or I guess if you think the US is a bane for the world, then the optimum immigration would be less than the domestic welfare-maximizing rate.]
I'd love for some EA person to do a rigorous calculation but my spitball guess is that if I don't eat meat and it reduces the total population of farmed mammals and birds, the odds of a pandemic killing billions of people in the next few decades might be reduced by at least one part in ten billion.
That's a good enough reason for me and I think it should be good enough for everyone.
If it makes you feel good- great. But I just personally don't really believe in these kinds of individual consumption things. I think they are frankly negligible at best, and a distraction at worst. If we need to conserve water, the government needs to invest in the appropriate infrastructure and technologies to do so, and also use carrots and sticks on the agricultural sector to grow sensible crops. You closing the tap conscientiously isn't going to change much. By the same token, if antibiotics to livestock is a problem, regulate it away just like you did to ozone-harming chemicals etc. etc.
In some cases, lots of individual early adopters can have a large effect on the existence of a market.
Look how many meatless meats products there are now because vegans/vegetarians wanted them and bought them, and now better ones are out there and sometimes people who just want to eat _less_ meat buy them.
Yes, I think the government should take a stand on the antibiotics in animals, but individually buying alternatives helps show there's a market for them and can drive some production changes on the margin.
I haven't gone vegetarian for this, but reduced antibiotic use in animals is the reason I try to get organic(or at least "no antibiotic" - although these are _usually_ a package deal) meat in particular.
Restricting human population growth is one way to reduce the harm from pandemics, but it’s an extremely expensive way, since population growth is so good. We should do cheaper things instead! (eg investing more in mRNA technology and vaccine manufacturing capacity).
There's a difference between a larger US population and a larger world population. It's possible (likely, I'd guess) larger immigration inflows to the US and other high income countries will result in a lower human population over time, because of the propensity of immigrant women (and especially their daughters and granddaughters) from lower income countries to have fewer children once they've left their home countries.
Other things I personally like and believe Matt advocates for -- like increased urban density and significantly increased use of public transportation -- seem like they'd hasten a spread in America too
Do density or public transportation make much difference? Even if everybody lived in a homestead spread at one mile intervals and drove everywhere in a car, you would need people to be making whatever food people couldn't grow themselves, working in garages (to make and repair the cars) and oil fields and refineries or power stations (to produce whatever the car runs on) and factories (to make whatever people can't make themselves). And I seem to recall the deadliest outbreak in America on a per-capita level was in South Dakota?
The fact that this post could be read and commented on avidly by large numbers of people now whereas had it been written in, say, 2018, it would have been greeted with a few sage nods and then people would move on should tell us something. And that something is the way presentism manipulates our attention.
Are future pandemics a threat? Sure. So are lots of things. If the New Madrid fault erupts again like it did in 1812, not only would the devastation be biblical but it would so direct our attention to earthquake-proofing infrastructure (too late!) as to make our heads spin. If one terrorist managed to bring down an airliner with a MANPADS, we would talk and act about nothing else.
We'll always have diseases new and old afflicting us, but the big ones like COVID and Spanish flu are likely to remain fairly rare, no matter what our presentism biases scream at us. The question is how do we take sensible steps to avert or mitigate threats while we pay requisite attention to all the other low-probability catastrophes that may hit us in the coming decades.
I quite agree. Hence my disdain for those who think we should not be looking for the next biological threat whether in the wild or through gain of function research. Imagine applying that logic to a low risk but potentially catastrophic event like an asteroid strike. No one says that if we stop looking for asteroids that might intercept Earth's orbit then it makes it less likely to happen.
There are better masks already on the market: Cambridge Mask makes comfortable adjustable reuseable FFP2 (European equivalent to N95/KN95) masks.
They are essentially an FFP2 filter sewn inside a comfortable cloth mask, but getting the full authorisation meant they have had to pay a lot of attention to the way the cloth sits on the face of the user and how good a seal they get.
So why aren't they everywhere? Why aren't they making an enormous profit? No-one in government or public health is saying that some masks are better than others, or more comfortable than others - resulting in most people having just tried an early-pandemic cloth mask or a surgical mask and never really considered using something better.
I'm a happy customer; this is not a paid promotion for Cambridge Mask; it is a personal recommendation.
That, I think is a different question. There are still lots of people wearing a mask of some description, but most of them seem to be wearing the same cheap bad masks we had at the beginning of the pandemic, or wearing disposable white FFP2/KN95/N95 masks.
TLDR from my skim of the article: Not quite as good as N95 perhaps - they're FFP2 which is perhaps slightly lower than N95 - and you want the headband if you want comfort - otherwise they have the standard earpain problem.
If they fit well, they're good, if they don't, they aren't.
P.S. I'm shocked by the sheer variety of other masks mentioned. It really bogggles the mind that there are so many products out there, each with their many various pros and cons, and there is literally zero official guidance. Such low hanging fruit!
I'm not sure I've seen an actual N95 that goes on the ears. KN95s do, but generally not N95s. The N95s trouble is normally the cutting into the face pain.
$32, though there are usually some on sale for much less. They cope with about 300 hours of use, so that's equivalent to quite a lot of single-use masks.
The Goodall “quote” should be corrected. As the link makes clear, what you quoted is someone’s analysis of what she said, not what she said.
Relevant excerpt from https://www.politifact.com/factchecks/2022/jul/27/instagram-posts/no-jane-goodalls-population-comments-didnt-spark-p/
“ The poster expands on his claim in the video, in which he plays a clip of Goodall’s remarks, then cuts in to ask:
"What was the population in the year 1500? About 500 million. What on earth could take place that would cause a planet with 9 billion people on it to be reduced by 95% to 500 million? Hmmm…I wonder if a virus could do that?"”
Is there a companion piece coming up that looks at reforming our public health agencies and improving their ability to adequately respond to new pandemics? That seems like a big part of being prepared for the next big one.
Also, what does good preparedness look like at the local or state level? Let’s say I’m the mayor of Orlando and my public health department has been doing wastewater monitoring and they tell me a scary new disease is detected. What should I do? What’s the response plan?
I would reform the CDC make infectious diseases thier only focus.
Also make sure the FDA is fixed and they acknowledge the costs of inaction
That's an idea. Have one institution focused only on diseases with externalities -- I get Corvid and I can give it to someone else -- and another focused on diseases where outside intervention is a public good -- it costs little more to inform everyone to avoid contaminated lettuce from source Y than to inform only on person. Whether they really should be separate institutions may depend on possible complementarity in the inputs (outreach? data gathering?) into carrying out the two different missions.
Tell your folks to take the vaccine that's ready go as NYC is doing for polio. Run public service announcements on the local Fox channel.
I feel like this may be a midwit take, but my initial reaction is that it might be good to create a Pandemic Prevention Agency in the federal government. Not just an office in the White House like the one Trump shut down, but an actual agency as big as CDC with career staff. I'm not exactly what kind of powers it should have, but it seems like CDC (its peculiar bureaucratic failings aside) has a different mission than the kind of stuff necessary to respond to pandemics.
What is the mission of the CDC though? And how would yet another agency not fall prey to the same bureaucratic failings? The real problem revealed by the response to Covid in the US is that many Americans don’t trust public health expertise or the federal government. Another federal public health agency isn’t going to change that.
The CDC used to be focused on stuff like this.
It morphed into a more academic institution over time.
CDC should only be infectious disease. Stay focused on that
I still remain confused why Everybody Knows ventilation is the greatest thing since sliced idiom, but in practice it's gotten implemented...not much at all? Or even just maintaining/repairing already-existing HVAC systems. Even outside of covid, I've heard so many positive cost-benefit things about reducing indoor air pollution and increasing oxygen levels that it sure feels like a low-hanging $20 fruit lying on the ground. Why don't we do more of this? Unlike pan-vaccines, it doesn't even require new science or enormous financial resources..."Gentlemen, we have the capability!"
Separately, it'll be kind of sad if factory farming ends because all the animals got killed by avoidable diseases before we could reform the system intentionally. I hope it's even possible to go back to traditional agriculture, if such a fate befalls our livestock.
Improved ventilation *does* take huge amounts of resources. You can change building codes to make future buildings have better airflow (though you’ll have to argue a lot with the fire department about how this interacts with fire safety) but for existing buildings there’s not all that much you can do. You can replace all the expensive equipment that runs the HVAC, but that’s only going to help a little. It’s not like you can go through every single building built in the last 30 years and add openable windows, more outside air sources, etc.
Does it take huge amounts of resources though? Sure, moving from MERV 8 to MERV 13 filtration might require stronger blowers, but it does greatly decrease PM concentrations of the size that carries COVID _and_ is a regular improvement homeowners can opt for when purchasing HVAC. https://www.epa.gov/indoor-air-quality-iaq/what-merv-rating
Or hell, an elementary school can put $200 HEPA filters in each room of a school for ~$10k. Considering the windfalls states received lately from feds, this doesn't feel crazy on a per-school basis.
If that's really sufficient, then maybe this isn't as big as I think. I was assuming that you actually need to increase air flow though in a lot of the modern buildings that have drastically reduced air flow for fire code and energy standards. And that would mean actually creating more physical openings.
Would love to hear from HVAC / AQ experts on how hard it is to increase the turnover rate (air exchanges / hr) and to what level for maintaining low % of PM size that carries viruses. In a school, say.
You’re likely right that it’s not just a filter thing but also a turnover issue too.
And you just know that the next big virus will spread primarily via fomites.
Or skin to skin contact.
“Why don't we do more of this?”
Because (almost) no one really believes the benefits are worth the costs.
And, more immediately, if you increase the fresh air flow in a modern commercial office building, the building is instantly worth less. [More fresh air = higher HVAC costs = lower operating margin - commercial office properties are priced on multiples of projected earnings.]
Is that so? I suppose I got suckered, then...that blows. Every once in awhile these sorts of Simple Uncontroversial Solutions crop up and it seems like an easy win-win-win, but I guess I should know better by now than to assume the veracity of such narratives. "If it were that easy/good, we would have done it already," says Econ 101. (Yes, I know, all theoretical models are wrong, but some are useful...)
Slow Boring always makes me *want* to believe this isn't a null possibility-space, though. That's the quixotic quest-vibe here. Although the same logic applies - the fact that Matt still has a job writing this particular beat demonstrates that things aren't that simple, often. It's sure tempting to wish they were, though. What a nicer world that would be.
I’m inclined to believe in those benefits for the most part. But if a source says oxygen levels increased, I wouldn’t consider it reliable.
I actually think that this post is a smidge misleading in focusing on bioterrorism. Studying pandemics and teaching public health has convinced me that the major threat most Americans fail to think about is the growth of megacities in sub/tropical waterfront zones in less wealthy countries. (If you are curious about my work, including the hilariously on-point museum exhibit I did in November 2019 on the historical experience of pandemics, check out my website.)
Regardless of whether you think Covid was a lab leak, its emergence in a Wuhan wet market perfectly fits this set of circumstances:
1) Wuhan is a "new" megacity (i.e. more than 10 million residents, explosive growth in the last 50 years), which means that many residents are first- or second-generation city dwellers with deep continuing ties to other places.
2) Like most of the newer megacities, it has a relatively less affluent population, which is one reason--though not the only one--why it has a huge wet market.
3) It is unusual for being inland, but it is still constructed in a historic wetland, on the Yangtze.
4) Wuhan is well-connected to the global market / production system.
I will not go long on the specifics, except to say that this is a more or less perfect set of circumstances for nurturing new infectious disease outbreaks. Some of the factors are probably obvious to everyone who reads this (density, population, etc.), but some you might not be thinking about. Just to name two, wetlands and warmer areas are more conducive to both pathogens and vectors (like mosquitoes), and cities with high percentages of first- and second-generation rural-to-urban migrants experience constant flows in and out because of internal travel (go back to the village to visit family), which means you basically have a much higher flow of humans across different immunological / disease zones.
Bottom line is that I worry a lot less about bioterrorism than about old-school novel infectious disease outbreaks, whether they are species jumpers, mutants of existing pathogens, or lab leaks. And I worry a lot about those. We have lived through a bunch of either actual or potential events already in just my lifetime--HIV, ebola, SARS, MERS, flu, Covid, zika, monkeypox, resurgent resistant strains of TB and gonorrhea--although most of them went unnoticed because they did not end up being a big deal or haven't become a big deal yet (i.e. the last flu pandemic was a relatively mild strain). But the truth is that we are getting hit on the regular. A Covid style event was just a matter of time, and the same is probably true of something worse.
I suspect that bioterrorism is harder than we suppose. Life forms are very complicated. You may think you have engineered the most awesome virus or bacteria in the lab but that doesn't guarantee that dumping it in the reservoir or spraying an aerosol in a crowded train station will lead to vast numbers of people dying.
Of course, even a very limited "success" would be very scary.
Do you have a link to your website?
It's at https://www.jeffreycwomack.com. The exhibit was called "Going Viral"; you can see our official poster, including the now-hilarious November 2019 launch date, on the aqua colored block on my work page. There is a link within that goes to the tattered remains of the exhibit, but it's not much to see at this point, which makes me sad. But you can also find some stuff from the early pandemic on my blog page.
The tragic story of the exhibit is that it was conceived as a counterpoint / closing piece to the museum's exhibit on the 1918 flu pandemic, which launched that same fall (maybe the same month?). That exhibit, "Spit Spreads Death," was really heavy on digital interaction, with a bunch of touch-screen computer displays that let you do cool stuff like zoom in on particular blocks of Philly to see who died in your home during the flu pandemic. My exhibit was therefore designed as a totally non-electronic display with a heavy physical interaction component, as kind of a counterpoint palate cleanser to all the screens.
It was a three-part setup that basically walked you through historical ideas about infection before winding up in the modern era, with germ theory, and it paired the theories with particular diseases and epidemic events. In each section, we had sensory experiences paired with the images and text to help the participant imagine themselves in an epidemic event, trying to understand that event with the prevalent theories of the time. My favorite was cholera, where we had set up this little area as a mock-up urban alleyway, with sewer covers and windows and the like with smelly sachet bags; the idea was that you could replicate that famous Puck image of the health inspectors and go looking for the miasmatic smells causing the outbreak.
The final section concluded with germ theory, starting with Lister (the museum has one of his carbolic acid sprayers) and going through measles, which as you may remember had caused some outbreaks in low-vax communities in the summer and fall of 2019, including most famously the Disneyland and New York episodes. We did a lot of stuff that I am proud to say held up really well in the pandemic. We had a great section helping patrons see the interesting parallels between the old Plague Doctor costume and the stuff worn by modern medical professionals in high-risk situations like outbreak response (the bunny suit) and in surgical theaters (mask, gloves, eye protection, etc.).
In keeping with my own work in public health, we also had some fun material on hand and respiratory hygiene and vaccination. We put in this great mini-mock-up of a SEPTA bench and a lenticular--one of those things where it shows a different image from different angles--where you could see first a cartoon image of people riding a subway car, then an image of the same scene, but with points of contamination / germ contact highlighted in green (i.e. the air in front of a coughing child). It was a great exhibit, and I think everything held up really well to the actual experience of a pandemic.
Then Covid hit, and when the museum reopened, well, you can guess how excited people were about an exhibit where you walk around imagining yourself in a pandemic and interacting with exhibits that you were supposed to touch and smell. Heavy sigh. It was supposed to run until 2022 or '23, but instead they quietly pulled the whole thing down shortly after the museum reopened. It was a real bummer; we had spent a year and a non-negligible budget on all those interactive displays (building stuff strong enough for patrons to interact without having it break is surprisingly expensive because it has to be really robust down to little details). They left a little website up, which is linked on my site, but it's mostly just a bunch of teaser text.
This sounds amazing! Is there any chance you could persuade the museum to get it back up next year, maybe with an appendix about covid? Or are all the physical objects now gone?
I honestly don't know what happened to them. There was a great Plague Doctor mask mockup that someone walked away with, and I wish that someone had been me. It's probably just in storage.
But what was the population in those periods? Any idea? As far as I know, no city crossed the ten million mark (the modern definition of a "megacity") until the 20th century, and I'm pretty sure that Wuhan crossed it only in the post-WW2 period. But, hey, I'm happy to be wrong about that.
This is what I mean by "new," and it is specifically why I put quotation marks around the word. Wuhan is obviously not a new city, but it has a large population of residents who are relatively new, by which I mean one to two generations deep living in the city. That matters because, as I said, people in the first and second generation are much more likely to still be cycling back and forth to the countryside, because they still have family living out there or similar reasons to return. These internal movements are a significant source of pathogens moving into and out of cities that have experienced recent growth (and by "recent," I mean post-1950).
To give another example, I grew up in Houston, and I was the second generation born there; my dad's parents had moved from rural east Texas to Houston to work in the oil refineries. As a result, they still had family and some land in East Texas. Dad, as a kid, spent every weekend in a little town called Crockett. I, as a kid, spent much less time there, but we still went there 10-20 times a year, in part because Dad's dad spent an increasing amount of time there post-retirement. We did a lot of outdoors activity there. As a result, I was at much higher risk for, say, lyme disease exposure than you would expect for someone living in a white-collar upper-middle-class suburb of Houston. That is much less true of my son, who has been to Crockett maybe three times in his whole life. When he visits his grandparents, he goes to a suburb of Houston, rather than to the property in Crockett.
Does that make sense? It's not the newness of the city. It's the newness of the residents, as described by population growth patterns.
Wuhan has been heavily populated *by contemporary standards* since the Han Dynasty.
But for the majority of the Qing Dynasty the combined populations of Hankou, Hanyang, and Wuchang hovered in the 1 million range, and their links to hinterlands in places like Southwestern China were nonexistent.
Wuhan is pretty marginal in terms of bats; the local livestock populations are mostly chicken, ducks, and pigs, so the same illnesses affect it as do Raleigh, NC, lol.
It was very much a matter of blind chance that COVID broke out into a form which could easily spread between humans there as opposed to any of Chongqing, Chengdu, Guiyang, Kunming, Changsha, or Nanning, around which the relevant bat populations are actually located.
Could just as easily have been Xiamen, Beijing, or Shanghai as Wuhan.
Or, again, someone was selling "used" animals out the backdoor of the WIV. It's not the most likely zoonotic route but it cannot be ruled out because the Party won't fucking gather the data.
I mean, yes. That's the point. It could definitely have just as easily happened in those megacities or in many of the other, non-China megacities that have grown up in the last 50 years.
What I wrote is that modern megacities are particularly problematic centers for the outbreak of epidemic disease because of common qualities that differentiate them from the smaller cities with which most Americans are accustomed. What, precisely, are you arguing with me about? I get the you misunderstood my usage of the word "new"; is that what is bothering you? I don't think you actually disagree with me that Wuhan did not have ten million residents a hundred years ago. I think you agree that is a relatively novel development because...it is.
Like, precisely what statement from my comment that you think is wrong, and why did you go off on bats, a thing that I did not mention, almost as though...I knew better than that? I'm genuinely curious, because if I'm screwing up something in the public health literature that I teach, I should fix that misunderstanding. But right now I can't figure out what you are getting at, which leads me to believe that there's a misunderstanding.
I didn't write the post to which you responded, and my response to you was... agreeing with you and elaborating further on a tangent?
Was there a tonal or language component to that post which led you to believe I was *disagreeing* with anything you said?
I mean, honestly I was confused about the whole thing. It's the end of the quarter and I'm pulling some late nights right now on account of working three jobs this summer (long story, bad choice, will endeavor not to repeat), so I'm probably just being brain-fogged. It's why I wrote that last paragraph.
"The main reason I’m skeptical of the Covid-19 lab leak skeptics is that they seem to treat the idea of a lab leak as inherently improbable."
"That being said, I don’t particularly want to rehash the Covid-19 origin story because I think it’s become counterproductive."
Ooooooh, so close to admitting that the evidence points in the other direction!
But in all seriousness, I think your first statement is wrong. It's not that most lab leak skeptics treat that hypothesis as improbable (on the contrary, it very much is something we should worry about, as you nicely lay out today). It's that it's always seemed far more likely to be a zoonotic origin, and the evidence for the lab leak doesn't amount to anything more than "there's a virology research institute in Wuhan and the Chinese government is untrustworthy." Which, to be fair, is not nothing, but the onus really should be on the lab leak proponents to build a better case for it. Meanwhile, the zoonotic hypothesis has been carefully and thoroughly investigated (see https://www.science.org/doi/10.1126/science.abp8715, and Derek Lowe for further commentary: https://www.science.org/content/blog-post/origins-pandemic---under-rug). But as you rightly state, we need to worry about zoonotic origins as well! So I'm not sure why we can't just say "accidental lab leaks are possible and have nearly happened before, even if not in this particular case."
The problem with all of this is that the virus is *obviously* zoonotic in origin, and *obviously* had its first major superspreader event at Huanan.
The question, which is basically unknowable given the complete and utter obfuscation the Party is engaging in, is how the hell an initially bat-borne coronavirus almost certainly originating in Yunnan or Guizhou came to be in that market.
There is the obvious possibility: someone brought animals raised or captured in that region to Wuhan for sale. The chances are obviously astronomically small that any given civet, pangolin, or racoon dog from SW China would already have the virus but if you sell enough of them nationwide, it becomes an inevitability.
There is also the other obvious possibility, that certain people motivated by entirely non-scientific factors feel the overwhelming need to deny: The laboratory whose main reason for existence is the study of animal-borne viruses, especially bat-borne ones from SW China, located infected animals in its extensive surveying of the region, brought them back for study, and "misplaced" a few that ended up at Huanan.
The reality is that we'll never, ever know. And, and I feel the need to state this again, the CCP clearly and obviously does not regard the latter as an impossibility or even an unlikely cause, because they immediately stonewalled the hell out of all investigation that could rule it out.
They themselves suffer from immense GIGO problems at the local level, and if someone fucked up in this manner you can be sure that a lot of data and records are missing or edited to cover for it, such that the echelons of the Party responsible for working with the WHO just can't be certain something embarrassing won't bite them on the ass if they were to allow a genuine investigation.
I wouldn't be surprised if the virus was circulating outside of Hubei for months, slowly, but acquired greater transmissibility (ie, a new variant arose) in Wuhan, perhaps because of a more ideal environment for transmission (greater population densities, or maybe it was simply the first city where an infected animal showed up at a wet market?). If it hadn't been Wuhan first maybe it would've been Chongqing or Changsha or wherever.
Without a doubt you're correct the Party doesn't regard the lab leak hypothesis as an impossibility (nobody should), but I'm not sure the "stonewalling" says much either way. I believe it's entirely possible there are secrets not related to Covid they want kept hidden, and they're just nervous. I also think the specter of pushy outsiders just rankles the fuck out of them. My sense is they've become awfully prickly and thin skinned about outside forces and influences in recent years—forces and influences they regard as malevolent. In a word, they're arrogant, paranoid xenophobes.
I don't entirely disagree, but I think you're overstating the case that the sole driver of their behavior is a sneering inferiority complex. That's definitely *one* of the drivers, but in this case I think the Party itself isn't completely sure what the hell happened and is making certain the muddy the waters as much as possible.
EDIT: Also, just to be completely clear, when I say "misplaced" above, what I mean is "I have worked in Chinese labs and the lower level employees are poorly paid and treated like shit, so many things with black market sale value go missing. A 'used' pangolin or civet could absolutely be among those things."
Yeah. I thought he was off on that statement, too. Labs leaks have indeed occurred, and absolutely cannot be ruled out in the case of Covid, but one thing the zoonotic spillover hypothesis has going for it is it's simply a vastly more *common* cause of pandemics than lab leaks. Pandemics have been around a lot longer than laboratories. Occam's razor.
I don’t think you can use the pre-1950 history as relevant evidence. You have to compare frequency of the two types of outbreaks in circumstances like the present. I think the balance still tilts in favor of wild zoonosis, but not as strongly as it does if you weigh all those decades and centuries when labs couldn’t leak.
Fair point. And lab leaks have indeed occurred. And indeed resulted in deaths (a leak of the SARS virus by a lab in Beijing resulted in a death in 2004, for instance). Still, have any *epidemics* resulted from lab leaks? I haven't been able to find an example. And again, we know natural zoonotic spillover has been a frequent, dreaded stalker of our species throughout its existence. That's not to say the Covid19 pandemic didn't result from a laboratory link in China. It's a plausible theory that cannot be ruled out yet. I do think the frequency with which zoonotic spillover has plagued (literally) homo sapiens is a vote in favor of this as an explanation, and from what I can parse via my limited layperson's capacities, this seems to be where the bulk of science community opinion currently resides.
But would it shock me if revelations at some point came to light suggesting compelling evidence that Covid was leaked by a Wuhan lab? Nope, not in the least.
I would agree that the onus of proof is on the lab leak proponents, were it not for the fact that the Chinese government is not at all collaborating with external investigators.
Throughout the history of investigation, destroying/hiding evidence, as our “partners” did, has been seen as indicative of guilt. People who aren’t guilty of anything shouldn’t behave as if they are.
We’ll probably never know, but some key actors were behaving as if they had something to hide. It’s human nature, not nutty conspiratorial thinking, to wonder why innocent people would behave that way.
To be fair, the Chinese government is *especially* prone to acting guilty even when it isn't. And Saddam Hussein did the same thing when he refused to let the weapons inspectors in.
Have you read the Science piece linked?
Isn't the steelman lab leak theory that it was zoonotic, but held at the Wuhan institute of virology?
I don't have a degree in philosophy, but Matt's reasoning sure sounds like a logical fallacy.
Also, a further point on the nature of "scientific inquiry" in totalitarian societies: https://www.science.org/content/article/pandemic-start-anywhere-but-here-argue-papers-chinese-scientists-echoing-party-line
Thought experiment - What if we knew this was a lab leak? What are the scientific and political implications? They seem pretty enormous. It turns into a Marvel movie where the people who saved us are the ones who caused the problem in the first place.
Not to beat a dead horse, but two of EA's biggest planks are pandemic prevention and widespread factory farming reform. It ain't all AI risk.
Matt’s post is a cri du coure for serenity. We are all going to die. We are much less likely to die in the next year than our pleistocene ancestors, our medieval european ancestors, our early industrial ancestors, or even Americans 50 years ago. Of course, our minds are really good at imagining ways we could die— asteroid risk, climate change, nuclear war, bioterrorism. Yet these exotic risks have killed very few people. It’s easy to imagine mass casualty scenarios precisely because we lack robust data on how these things kill people.
If I want to live longer, my best strategy is to eat fewer calories and less saturated fat and drink less alcohol. That strategy has proven results as obesity, clogged arteries and booze combine to kill millions of Americans every year. I should probably stay married, which also has proven longevity benefits. Controlling my appetites and maintaining my marriage are hard enough, and would be harder still if I walked around freaking out about AI risk.
“Honey, could you fix us a salad?”.
“No baby, I need to understand AI risk, why don’t you order pizza.”
“I wish you loved me enough to make healthy food.”
“It’s hard to focus on that when the world sucks so much.”
(queue the cork screw and possibly the divorce lawyers).
Strange energy here.
Throwing out actual risk of dying, you don’t have to go back very far to see that even with a virus much more safe than what Matt is writing about in this post likely caused a ton of harm to your specific life.
I didn’t much enjoy the state of the world in 2020. You don’t have to walk around every day terrified of the world ending, but advocating for better responses to the next virus seems fairly logical if you don’t want another large part of your life spent locked down or arguing about that etc… even if you’re not worried about any risk of dying.
I can’t actually tell what topic that Matt writes about would interest you if you’re not at least somewhat interested in how to prevent that situation again - “I don’t think it’s worth talking about how to improve zoning laws to impose my or others lives because it goes against serenity”.
If you feel like that straw mans what you’re saying, what are the consequences of what you’re saying? Matt’s post seems pretty straight forward of “let’s do some things that seem like it could help”. It’s not hysteric about existential risk really. Do you think we shouldn’t enact better pandemic response items?
We agree that 2020 sucked. We probably disagree on how it could have sucked less.
We were very far from crushing the curve, even the iron fist of the Communist Party of China could not contain the virus, nor have they figured out how to crush the curve after almost three years.
Serenity was a better option. On an individual level, serenity would have involved:
1) healthy young and middle-aged workers understanding that their individual risk was low and that their duty to society was to carry on with their jobs and develop a cadre of naturally immune workers
2) some courageous octogenerarians deciding that a 1% risk that a family Christmas would kill them was worth taking when they only had a few Christmases left
3) heroic young volunteers doing challenge trials-- an act far safer and just as noble as storming the beaches at Normandy
4) a calm acceptance that a dying to do one's job or to love one's family is a more beautiful death than 90% of Americans experience today; and
5) targeted efforts to help vulnerable, high value workers (eg 60-year-old teachers or judges) work remotely, while the less vulnerable took the physical risks of maintaining order in the classroom or court.
Ehh. This is a fantasy just as much as the "we should have locked down everything until the virus went away" is a fantasy. People's behavior was always going to change in response to COVID, even if the government didn't mandate or support it.
"Keep Calm and Carry On" would have simply lead to a lot of people suffering more ancillary consequences and the economy suffering badly. Note how quickly Britain's initial policy of "isolate the olds and let the young people all catch it" fell apart under popular pressure.
Given the speed of spread, deaths, and complete lack of effective treatments in the first 3-4 months, it's also a perfect way to scar everyone so badly that 30% of the population is still playing "COVID Warrior" in 2022 instead of 5%.
Any alternate history is a fantasy. Only the actual was possible.
I mean... ok? I disagree, but if that's how you want to play it, then I'll up the statement: this is a fantasy that was completely impossible from day one as it ignores the basic human condition.
There are plenty of ways that events might have played out starting from January 2020, your vision is NOT one of them.
I'm not sure I believe that 'dying to do one's job' is an easy sell to people.
Perhaps to surprise you, I don’t actually really disagree that strongly with much of this. I particularly agree with 3 and 5, generally with 2, and would need more info about what you mean by 1 and 4.
That said, it doesn’t really answer my prompt. That’s what your lifeview of serenity would’ve advocated for in 2020. Right now, it appears your lifeview of serenity advocates for not doing any work to help prepare for an eventual future disease? The lifeview appears to be “don’t prepare for future bad possibilities, and then when they come, accept they came with the lack of preparations we’ve done with serenity”
'...develop a cadre of naturally immune workers...."
There is no natural immunity to COVID-19. People get reinfected twice, 3 times, 5 times. Getting it once does not protect you, or protect others from being infected by you on a later reinfection.
We did not know that two years ago. We know it now. "Herd immunity" might have worked with a different virus. It never would have worked with COVID-19.
I think we know there *is* natural immunity but that “immunity” doesn’t mean “100% safe”. Even the unvaccinated are getting milder cases now, because they’ve mostly been infected before, and their bodies are developing better responses.
And with classic COVID, both wild immunity and vaccine immunity seems like it was a lot stronger than with delta or omicron.
Right. If you look at US death numbers of late (assuming they're reasonably accurate) it's hard not to conclude the utter endemicity of the virus in the States (and thus the near universality of antibodies in the populace) is protecting the country from excess morality at present.
Ehh, the transition from "occasionally deadly and always miserable" to "common cold" seems to be mediated by the *long-term* immune response triggered by multiple infections.
It's unknowable but the way to bet is that if we plopped a common cold coronavirus down in a large population with no historic exposure it'd do damned near exactly what COVID has.
In which case, the role of vaccines is to make that transition less deadly by beefing up the mechanisms of short-term immunity even if it's non-durable.
We really, really need population surveillance testing for the four common cold coronaviruses so we can finally understand things like asymptomatic infection rates and contagiousness in long-term endemic coronaviruses. Until we know what the endgame looks like we have no idea how near or far we are today.
I would have more respect for Matt’s post if he 1) said explicitly what proportion of gdp he wants to devote to mitigating long term risks and 2) explained what valuable activities we should do less of to invest in asteroid prevention, etc.
I think he thinks we have already invested enough in asteroid prevention. He’s asking a few billion a year for pandemic prevention - about 0.01% of gdp.
I don’t think his christmas list could be achieved for that budget. but if it could, 1) sure 2) thr interesting thing is his mental focus on how 0.01% of gdp should be spent
When there are big and valuable things that can be done cheaply, that is the *best* case for mental focus.
Why set up these things as tradeoffs? You can eat salads AND have a few cents of your tax bill go to subsidizing better ventilation and vaccine preparedness. They pass good cost-benefit tests even for pandemics LESS infectious/deadly than COVID, the PHE just does not think in cost-benefit terms.
It’s naive to think that individuals have infinite energy/time/bandwidth to devote to good health. Every minute I spend working out is a minute I don’t spend working. Every drink I don’t have with friends is an immediate pleasure forgone.
Very few people—even doctors— have medically optimal lifestyles. There are other, competing goods and we have to choose. Every minute spent thinking deeply about AI risk was not spent doing other things.
This seems nonsensical in that I don't think anyone expects that individuals have infinite energy/time/bandwidth. Thankfully, we're an advanced economy capable of excellent specialization. In this case, what we are advocating for is a general recognition that its an issue, an allocation of a small but impactful amount of resources to a small group of people to work on. This would enable us to be better prepared should future incidents occur.
This is no different from what we should be doing from a hundred (thousand?) different issues. We're a rich society! Really, really rich! We could spend .0001% of our GDP on this and wouldn't even notice it, but it might save millions of lives and a trillions of dollars in economic impact.
Granted everything has an opportunity cost, (I sort of skimped on my morning exercise today becasue I was especially interested in this SB topic :)) but I still don't get posing healthful living as a particular trade off with thinking about societal level problems.
I can understand a strong anti-hysteria stance. I don't think I understand this, which I read as a strong anti-caring/anti-prevention stance. What is the argument against *simply wanting some measure of preparation and contingency planning*?
What if the wife says "could you fix us a salad?" and the husband responds that we already live longer than our ancestors so the wife needs to learn serenity—that her attention would be better spent on keeping their marriage healthy, meaning not stressing him out with all of her focus on obesity and clogged arteries? That seems just as reasonable as your approach here.
“ which also has proven longevity benefits”
Staying married is correlated with longevity it’s not proven to cause longevity.
I dunno: I can easily imagine a man losing the will to live when there’s no one around to make him a sandwich.
Or just starving.
“The main reason I’m skeptical of the Covid-19 lab leak skeptics is that they seem to treat the idea of a lab leak as inherently improbable.” This statement strikes me as weasely imprecise and only correct (or “fair,” since it’s a “seems” statement) if you cherry-pick your skeptics or skeptical claims. Most prominent lab-leak skeptics I’ve read readily acknowledge the absolutely essential need for great care in lab settings because of the real risks—many seriously entertained (and subsequently investigated) the possibility. If “inherently improbable” is supposed to describe their estimation of the likelihood that “some lab leak of some disease happens sometime,” then I don’t think that fairly describes their view. Nor is it improbable that “someone wins the lottery.” But the likelihood of any one person winning the lottery is improbable, and so is the likelihood of any particular instance of a lab leak. For Covid, the fact that it emerged near a lab significantly raised that low baseline probability, but no one’s found evidence of any of the additional markers we would expect to find if there was a lab leak.
Does it matter for how much to subsidize ventilation/UV systems and get vaccines ready for use within weeks whether the pathogen arises from a crossover, lab leak or bio-terrorist?
This post is all over the place and in some spots nonsensical. I've been tangentially associated with the bioweapons community during my working career (consultant to the former Congressional Office of Technology Assessment as well as to the Dept. of State prior to the 3rd Review Conference on the Biological Weapons Convention and a participant in Federation of American Scientists' work group on this issue). Anything associated with high dread worries the public as Paul Slovic's seminal work in the late 1970s demonstrated.
Microorganisms mutate all the time (thank you Charles Darwin) and this has been a fact of life for centuries. Pandemics come and go (Black Plague, 1918-19 influenza, and 1957 Asian Flu, etc). The failed response to Covid-19 is multi-factorial and books have and will be written about this. All we can request of policy makers is to use common sense, prepare, and react.
Yes, we do need more antibiotics but recognize that the easy work of natural product screening has already been done and new approaches are required. However, recognize that most illness and fatalities arising from the bacterial infections shown in the table are more a function of the individual's health (malnourishment, immunocompromised, etc.).
If Matt set out to scare his readership, I guess he achieved that goal. He didn't scare me.
Do you disagree with the conclusion - basically “things could get a lot worse”, and “we could do a lot to prevent that from happening?”
Get worse: this seems fairly obvious. We learned that we’re entirely unable to prevent the spread of a highly contagious virus. Is it not possible that something as contagious as COVID but, say, 5x more deadly will appear in the next 25 years? Are the bio weapon concerns Matt raises not possible?
Prevent that: Do you disagree with anything in the last paragraph? Any reason not to advocate for, at least, most of it? In my view, US public health is way too invested in communication and public behavior (which I think we’ve learned is pushing on a rope), and not invested enough in some of the infrastructure Matt mentions here. Do you disagree?
the creation of bioweapons is quite challenging and delivery is even more complex. the only exception is the use of specific toxins to kill an individual (which has been done several times in recent history, usually with ricin). I don't lose any sleep worrying about bioweapons.
I'll not get into the COVID prevention as I spent the first eight months of the pandemic putting out a daily newsletter that dealt with all aspects of prevention, treatment and remediation (if you are interested, you can google my name and COVID-19 Resources; all the newsletters are archived there). Had people used well fitting masks (lots of data on this!) in the early days of the pandemic, the trajectory in the US would be quite different. Public behavior, which was horrible in this country (vaccine deniers etc) and is hard to change.
There will always be new pathogens arising whether it is a novel microbe that jumped species or an existing one that mutates. Improved vaccine development is a key tool here (though most people don't realize that a lot of this including mRNA vaccines was worked on during the Zika outbreak several years ago.
I could write lots more but it's all on my website.
I think many of the things in the solutions section are good ideas for general pandemic response though I am skeptical of some of them (like putting UV lights everywhere).
I don't want to put words in Alan's mouth but the essay seemed all over there place and nonsensical to me because the call to action (pretty generic preparedness) seems totally divorced from the hook (hypothetical bioterrorists can easily design incredibly specific pathogens). I think the idea that this imagined bioterrorist built up in the middle of the essay can create super advanced eluding pathogens but is going to be defeated by better monitoring and better masks is pretty weak.
How much would banning commericial antibiotic soaps help slow bacterial resistence development?
A lot less than a ban on routinely feeding antibiotics to healthy farm animals, which I think is standard practice in many places.
Very little as the compound in them is unrelated to all the medicinal antibiotics. Jeff Rigsby's comment about antibiotics in animal feed is the critical one.
Yep, 'tis a mystery why the infrastructure bill did not include money for ventilation/UV sterilization and universal vaccines or even just a bunch of MNR single strain vaccines for different families that could be tweaked for whichever strain of virus family Y turns up.
But in a way it's just part of the same mystery as to why these things were not done FOR COVID! [Hint it's more the fault of the PHE [Public Health Establishment than Donald Trump.]
The American Rescue Plan included plenty of money for the states that they were *supposed* to spend on ventilation for schools and such. Didn't really happen.
"Supposed to" or "could have?" And of course the availability of money presumes that school districts were already making deductions about which schools to close and not, which restaurants to allow to have indoor dining or not taking account of the ventilation. I did not mean to imply that the only thing missing from a proper COVID response was appropriation of funds by Congress.
"supposed to have" in that Congress and Biden highlighted ventilation as a main use case, but the actual language was pretty vague and states/cities/school districts could often do anything related to education. Bit of a mess tbh. It looks like some places (LA; Boston; Durham, NC; St Joseph, MO) went all in on ventilation and filtration and others just... didn't
https://www.pbs.org/newshour/health/how-covid-funding-could-help-improve-air-quality-in-schools
https://www.future-ed.org/financial-trends-in-local-schools-covid-aid-spending/
Governing and writing legislation seems like so much fun.
Thanks. It's nice to have someone modulate my views.
Isn’t the cost and energy requirements of sticking UV lights everywhere very high?
Compared to the benefits of not shutting down a school or restaurant?
Yeah ventilation is pretty straightforward and not particularly controversial. It has plenty of non-Covid benefits. But it’s not something you see. I suspect that is a big reason public health decided to spend its time fighting for elementary school mask mandates in the 2021-2022 school year instead of improving ventilation. The irony is that improved ventilation would probably have had a big benefit for the low income kids they claimed to be prioritizing.
They wanted to be "seen and not heard?" But even if that is right, why that "decision" (quotes becasue things happen more by inertia than by "decisions.")
There’s actually also a Tom Clancy novel about this idea (Executive Orders) where Ebola is weaponized and spread at a business conference. I believe President Jack Ryan ends up enforcing a nationwide lockdown (the national guard literally prevents people from crossing state lines) lol
Also Rainbow Six! (Which I think was also about unleashing Ebola)
Ebola was my favorite disease to be scared about in Jr. High because of the excellent film “Outbreak” with a peak 90’s Dustin Hoffman chasing a monkey, solving a virus threat and yelling at people in all the most satisfying ways.
I'm disappointed that the nuclear Clancy got a mention but not the bioterrorist Clancy.
I liked One Billion Americans a lot but today's post raises all sorts of issues against a larger world population (unless, perhaps, we go vegetarian on a large scale).
Concentrated agriculture just asks for this type of accidents. Some people (eg https://ourworldindata.org/mammals but estimates vary a bit, apparently) believe that mammal bio mass is currently 35% human, 63% livestock and 2% wild mammals (23%, 60%, 17% in 1900, respectively) and with a substantially larger world population, this is unlikely to improve.
I (and presumably Matt) just wants more of the world's population -- the most skilled/talented/entrepreneurial ones -- working in the US. The Idea is not One Hundred Billion Earthlings.
Sure. But a bigger issue that MY doesn't grapple with in this column is that arguably the entire concept of national competition that is embedded in your comment, and in One Billion Americans, and really in the entire post-Westphalia concept of the nation state, may be *the biggest problem* in solving the issues the article raises. After all, for all that Bin Laden demonstrated that a handful of real dickheads can do a huge amount of damage, the biggest risk in biosecurity comes from state competition, whether in the form of warfare or (much more likely) accidents from labs and scientists who are working on projects that are fundamentally about state competition and advantage.
Now, the inevitable retort to this is of course that political reality needs to be acknowledged, and that neither the extreme of abolishing nation states nor even the milder form of increased gloabal cooperation seem particularly realistic right now. But then again political reality is also why this stuff gets basically no traction in Washington as well.
One Billion Americans does not depend on geopolitical competition. We US-ians would be better off if we applied cost benefit considerations to who and how many immigrants we admitted. It's a nice side effect that widespread use of cost benefit analysis would increase the geopolitical weight of the US vis a vis countries with even worse political systems.
The comment doesn't make logical sense? If you are 'applying cost benefit considerations to who . . . you admit' then you are choosing who you want, which is to say you are in a competition (with other countries, ie geopolitical competition) for talent.
I agree that there is or could be a "competition" for global talent, but that need not be the motivation for choosing immigrants that optimize US well being (w/o counting plus or minus relative geopolitical weight). I agree that if we include geopolitical wight in the calculation, the optimal rate of immigration would go up, but the two considerations are separate. [Or I guess if you think the US is a bane for the world, then the optimum immigration would be less than the domestic welfare-maximizing rate.]
This is why I'm a vegetarian.
I'd love for some EA person to do a rigorous calculation but my spitball guess is that if I don't eat meat and it reduces the total population of farmed mammals and birds, the odds of a pandemic killing billions of people in the next few decades might be reduced by at least one part in ten billion.
That's a good enough reason for me and I think it should be good enough for everyone.
If it makes you feel good- great. But I just personally don't really believe in these kinds of individual consumption things. I think they are frankly negligible at best, and a distraction at worst. If we need to conserve water, the government needs to invest in the appropriate infrastructure and technologies to do so, and also use carrots and sticks on the agricultural sector to grow sensible crops. You closing the tap conscientiously isn't going to change much. By the same token, if antibiotics to livestock is a problem, regulate it away just like you did to ozone-harming chemicals etc. etc.
In some cases, lots of individual early adopters can have a large effect on the existence of a market.
Look how many meatless meats products there are now because vegans/vegetarians wanted them and bought them, and now better ones are out there and sometimes people who just want to eat _less_ meat buy them.
Yes, I think the government should take a stand on the antibiotics in animals, but individually buying alternatives helps show there's a market for them and can drive some production changes on the margin.
On the margin. Agreed.
I haven't gone vegetarian for this, but reduced antibiotic use in animals is the reason I try to get organic(or at least "no antibiotic" - although these are _usually_ a package deal) meat in particular.
I don't always succeed, but I bias towards it.
Restricting human population growth is one way to reduce the harm from pandemics, but it’s an extremely expensive way, since population growth is so good. We should do cheaper things instead! (eg investing more in mRNA technology and vaccine manufacturing capacity).
There's a difference between a larger US population and a larger world population. It's possible (likely, I'd guess) larger immigration inflows to the US and other high income countries will result in a lower human population over time, because of the propensity of immigrant women (and especially their daughters and granddaughters) from lower income countries to have fewer children once they've left their home countries.
Other things I personally like and believe Matt advocates for -- like increased urban density and significantly increased use of public transportation -- seem like they'd hasten a spread in America too
Do density or public transportation make much difference? Even if everybody lived in a homestead spread at one mile intervals and drove everywhere in a car, you would need people to be making whatever food people couldn't grow themselves, working in garages (to make and repair the cars) and oil fields and refineries or power stations (to produce whatever the car runs on) and factories (to make whatever people can't make themselves). And I seem to recall the deadliest outbreak in America on a per-capita level was in South Dakota?
IF we did none of the cost effective things that Matt is talking about, then yes, we'll have to rely employ cost-INeffective measures to reduce harm
The fact that this post could be read and commented on avidly by large numbers of people now whereas had it been written in, say, 2018, it would have been greeted with a few sage nods and then people would move on should tell us something. And that something is the way presentism manipulates our attention.
Are future pandemics a threat? Sure. So are lots of things. If the New Madrid fault erupts again like it did in 1812, not only would the devastation be biblical but it would so direct our attention to earthquake-proofing infrastructure (too late!) as to make our heads spin. If one terrorist managed to bring down an airliner with a MANPADS, we would talk and act about nothing else.
We'll always have diseases new and old afflicting us, but the big ones like COVID and Spanish flu are likely to remain fairly rare, no matter what our presentism biases scream at us. The question is how do we take sensible steps to avert or mitigate threats while we pay requisite attention to all the other low-probability catastrophes that may hit us in the coming decades.
I quite agree. Hence my disdain for those who think we should not be looking for the next biological threat whether in the wild or through gain of function research. Imagine applying that logic to a low risk but potentially catastrophic event like an asteroid strike. No one says that if we stop looking for asteroids that might intercept Earth's orbit then it makes it less likely to happen.
There are better masks already on the market: Cambridge Mask makes comfortable adjustable reuseable FFP2 (European equivalent to N95/KN95) masks.
They are essentially an FFP2 filter sewn inside a comfortable cloth mask, but getting the full authorisation meant they have had to pay a lot of attention to the way the cloth sits on the face of the user and how good a seal they get.
So why aren't they everywhere? Why aren't they making an enormous profit? No-one in government or public health is saying that some masks are better than others, or more comfortable than others - resulting in most people having just tried an early-pandemic cloth mask or a surgical mask and never really considered using something better.
I'm a happy customer; this is not a paid promotion for Cambridge Mask; it is a personal recommendation.
“So why aren’t they everywhere?”
Maybe because there’s no need?
That, I think is a different question. There are still lots of people wearing a mask of some description, but most of them seem to be wearing the same cheap bad masks we had at the beginning of the pandemic, or wearing disposable white FFP2/KN95/N95 masks.
Website ? Cost ?
I found this review which doesn't seem to be sponsored:
https://breathesafeair.com/cambridge-mask-review/
TLDR from my skim of the article: Not quite as good as N95 perhaps - they're FFP2 which is perhaps slightly lower than N95 - and you want the headband if you want comfort - otherwise they have the standard earpain problem.
If they fit well, they're good, if they don't, they aren't.
P.S. I'm shocked by the sheer variety of other masks mentioned. It really bogggles the mind that there are so many products out there, each with their many various pros and cons, and there is literally zero official guidance. Such low hanging fruit!
I'm not sure I've seen an actual N95 that goes on the ears. KN95s do, but generally not N95s. The N95s trouble is normally the cutting into the face pain.
You can't get N95 certification for a mask that goes on the ears. KN95 or FFP2, yes, but not for N95.
Super helpful, thanks!
https://cambridgemask.com/ or https://us.cambridgemask.com/
$32, though there are usually some on sale for much less. They cope with about 300 hours of use, so that's equivalent to quite a lot of single-use masks.
Big "Don't Look Up" vibes in today's column.
And yes, the total failure to do much reforming of pandemic preparedness in the US is incredibly discouraging.
More people than need to be are weirdly obsessed with the lab leak hypothesis.
Here's the thing: both lab leaks and zoonotic stuff needs addressed urgently and that doesn't change based upon whether COVID came from a lab or not.