1) Pandemics are a Solvable Problem
Pandemics are not the kind of problem to be endured or ameliorated through medication. Pandemics can be solved – completely and permanently – and that should be our goal. As we rebuild our societies post-Covid, we should reject any plans or strategies promising anything less. We can solve pandemics through prevention (not cure) and that solution is achievable with our current technology. In this post I will lay the foundations for that position. In later posts I will develop the strategies for achieving that outcome.
Problem Solving
‘All life is problem solving’, as the quote goes. I’m inclined to agree. Our day-to-day lives are full of problems to be solved, from the small, simple, and routine, like how to tie your shoelaces, to the big, complex, and seemingly irresolvable, like how to govern our societies.
Of all the problems we face, some we have solved and others we have not. Of the problems we have not yet solved, there are also two classes: those we could solve if we really wanted to, and those we could not, either because we lack the resources or the problem is inherently unsolvable.
For example, no economic policy could be described as correct or optimal – despite what the economists might tell you! There is a no such thing as the perfect budget, but even if the government did by pure chance manage to deliver the best possible allocation of taxpayer funds, how would we know? What real-world outcome would confirm it? The same can be said for the even simpler problem of monetary policy: we will do our best in the moment to make the right decisions, but we can only guess in hindsight at what the ‘correct’ answer would have been.
In contrast, there are simpler problems with clear and unambiguous solutions. Basic algebraic expressions like 2X = 6 can always be solved for X. These kinds of problems have a correct answer, we know how to identify it, and we can confirm that we have done so too. It is taken for granted that we can solve problems like these directly, completely, and without controversy.
What Kind Of Problem Is A Pandemic?
Perhaps surprisingly, pandemics are more like simple algebraic equations than macroeconomic policy-making. They are a class of problem which can be solved, in theory and in practice, and with the technology of the day. We can get the right answer and know for sure that we have it too, as I will clarify below.
Having lived through the chaos and catastrophe of the Covid-19 pandemic, you might be sceptical of that claim. How could a problem so big and complex and destructive be so simple to solve? We had every incentive to do so, yet we didn’t even get close. How can I make such a grand statement?
Well firstly, contagious outbreaks are exponential variables, so they can become very complicated very quickly – if we let them. Secondly, a pandemic is the last stage in a long process which begins with a single infection. If left unimpeded, it will spread throughout cities and across travel networks and eventually grow into a regional epidemic covering multiple countries. At that point, a pandemic will be hard to avoid.
The lesson, I argue, is not to leave it unimpeded. In fact, the sooner we impede the outbreak the better. If we can find the pathogen while it is confined to a single country, and we can respond quickly and decisively, then we can stop the outbreak before it has spread far enough to reach pandemic status – problem solved! At that point the outbreak can be surrounded and suppressed, with the elimination of the pathogen being the ultimate confirmation that we have indeed solved the problem.
With that approach in mind, the speed of our response will be key. The sooner we identify the pathogen, the smaller the outbreak will be at the time, and the easier it will be for us to eliminate it. It will be a lot cheaper in terms of resources spent too… but that is a conversation for another day. What matters for now is that speed can improve our pandemic performance by orders of magnitude, and that is what we will need if we are to permanently solve this problem. It is also the reason why I am so confident that we can.
Pandemics Can Be Solved; They Are Solved Through Prevention
The solution to the problem of pandemics is not one we apply after the fact, like a medical treatment. It’s one we have in place at all times, ensuring that the pandemic can never take place. We don’t wait for the pandemic to arrive, and then spring into action with our solution. Instead, we spring into action at the first sign of danger to nip it in the bud. We manage the risks while they are still risks. Prevention over cure.
Sadly, this seems to fly in the face of the conventional wisdom on pandemic responses.
The prevailing sentiment seems to be that pandemics just happen, like the weather, and the only thing we can hope to do is to endure them better. This school of thought calls for ‘preparedness’, since it is taken as given that there will be more pandemics, we must be prepared for them, just as we have umbrellas for rainy days.
While this perspective might sound reasonable, it gives little thought to risk management (managing risks while they are still risks) and I fear it only increases the likelihood of experiencing the disaster we seek to avoid. Taken literally, we are preparing for the worst possible outcome, instead of planning to prevent it. Pandemic preparation, in other words, risks becoming a self-fulfilling prophecy.
That this perspective has become the conventional wisdom is due in part to the fact that many of the people in senior pandemic policy-making positions are medics (understandably). Medics are trained in cure, not prevention, so they only act once the risk has materialised (i.e. when someone has become sick) at which point they administer a medical treatment. But what if you don’t want to sick in the first place? And what if the disease is contagious, and it’s not just an individual but the whole population at risk? Medicine isn’t well-equipped to deal with these situations.
I also find the perspective to be a bit depressing, as it implies that we have no agency over our outcomes, and that we should learn to endure the most unpleasant circumstances better, instead of aiming to ensure that we never have to experience them again. There’s an air of acceptance and defeat to pandemic preparedness, which I cannot abide. Fortunately, this perspective is also plainly wrong.
Contagious outbreaks are reflexive: the outbreak affects our actions (like the weather), but our actions also affect the outbreak (unlike the weather). Imagine if bringing your umbrella to work would mean that it was less likely to rain. It sounds bizarre, but that’s how contagious outbreaks work. My umbrella might not stop you getting wet, but my mask can stop you getting infected. Given that our actions (and inactions) determine the path of the outbreak, it is also the case that we have the agency needed to control them. We just need to learn how.
The Inter-Generational Obligation
Long-term thinkers have to be optimistic and ambitious. You can’t afford to aim low when you are looking centuries into the future. If one generation sells itself short, then all future generations will suffer, so it is essential that we aim for the best possible outcomes and hold ourselves to the highest possible standards. This is especially true when dealing with matters of public health and societal stability.
Even if we can’t fulfil our highest ambitions in our own lifetimes, we can still build the best possible foundations for future generations to complete the task. The more progress we make today, the more progress they can make in the future. We always want to hand over the world in better condition that we inherited it – this is our ‘inter-generational obligation’.
We can solve pandemics. We can permanently end the threat that pandemic-potential pathogens pose to humanity. And since we can, we must. However, a change of philosophy will be required: from passive acceptance to active ambition, from ex post medication to ex ante risk management, from pandemic preparedness to pandemic prevention.
And? Do you have a particular solution to guarantee pandemic prevention that deals with the specific logistical complexities inherent to the task, that can be applied to every country on Earth without being resisted?
“Step 2: Draw the rest of the owl.”
I see you state your solutions will come in later posts but I think it’s better to do that upfront given your rhetoric is currently not justified. Given your title I expect to see a theory of change that attempts to address the overwhelming challenges involved.
“Do you have a particular solution to guarantee pandemic prevention that deals with the specific logistical complexities inherent to the task, that can be applied to every country on Earth without being resisted?”
I don’t know what you mean by ‘without being resisted’, but otherwise, yes :)
The complexities are driven by the exponentiality of the variable. The exponentiality is resolved through speed, as I note in the piece. Exponential variables are exponential on the way down too.
“you state your solutions will come in later posts but I think it’s better to do that upfront”
We must understand the nature of the problem we are trying to solve before we start designing solutions. Similarly, we lay the foundations before we buy the wallpaper. Patience young grasshopper.
“Given your title I expect to see a theory of change that attempts to address the overwhelming challenges involved”
I cannot speak to your expectations.
The key point of this piece, which is reflected in the title, is that pandemics are the kind of problem that can be solved, in contrast to a problem like hurricanes which we can only hope to endure better.
Having worked with senior academics and policy-makers in my own country I know that this distinction is not well understood among those in positions of the highest levels of influence. Hence, why I take my time in making the point.