May 13 - Pandemics - Memos

[deholz]

Leave below as comments your memos that grapple with the topic of Pandemics, inspired by the readings, movies, & novels (at least one per quarter), your research, experiences, and imagination! Also add a thumbs up to the 5 memos you find most awesome, challenging, and discussion-worthy!

Recall the following instructions: Memos: Every week students will post one memo in response to the readings and associated topic. The memo should be 300–500 words + 1 visual element (e.g., figure, image, hand-drawn picture, art, etc. that complements or is suggestive of your argument). The memo should be tagged with one or more of the following:

origin: How did we get here? Reflection on the historical, technological, political and other origins of this existential crisis that help us better understand and place it in context.

risk: Qualitative and quantitative analysis of the risk associated with this challenge. This risk analysis could be locally in a particular place and time, or globally over a much longer period, in isolation or in relation to other existential challenges (e.g., the environmental devastation that follows nuclear fallout).

policy: What individual and collective actions or policies could be (or have been) undertaken to avert the existential risk associated with this challenge? These could include a brief examination and evaluation of a historical context and policy (e.g., quarantining and plague), a comparison of existing policy options (e.g., cost-benefit analysis, ethical contrast), or design of a novel policy solution.

solutions: Suggestions of what (else) might be done. These could be personal, technical, social, artistic, or anything that might reduce existential risk.

framing: What are competing framings of this existential challenge? Are there any novel framings that could allow us to think about the challenge differently; that would make it more salient? How do different ethical, religious, political and other positions frame this challenge and its consequences (e.g., “End of the Times”).

salience: Why is it hard to think and talk about or ultimately mobilize around this existential challenge? Are there agencies in society with an interest in downplaying the risks associated with this challenge? Are there ideologies that are inconsistent with this risk that make it hard to recognize or feel responsible for?

nuclear/#climate/#bio/#cyber/#emerging: Partial list of topics of focus.

Movie/novel memo: Each week there will be a selection of films and novels. For one session over the course of the quarter, at their discretion, students will post a memo that reflects on a film or fictional rendering of an existential challenge. This should be tagged with:

movie / #novel: How did the film/novel represent the existential challenge? What did this highlight; what did it ignore? How realistic was the risk? How salient (or insignificant) did it make the challenge for you? For others (e.g., from reviews, box office/retail receipts, or contemporary commentary)?

[isabelmw]

salience #framing

There is a wealth of material to talk about when comparing the movie Contagion and COVID-19, and I’m going to focus my memo particularly on two topics: the deadliness of MEV-1 and selflessness.

When COVID-19 was first spreading in the U.S., I distinctly remember reading several articles about the deadliness of the virus. Many of them contained the ominous warning that just because COVID-19 isn’t as deadly as certain past viruses doesn’t mean that it isn’t highly dangerous. Some articles were wagering that its higher transmissibility is worse than it being more deadly. Apparently COVID-19 straddles a very dangerous line of not being “quite deadly enough”, as many articles put it, to warrant the kind of public response that would get the country back on track. And I think we can see this playing out now, where COVID-19 was not taken as seriously by some sections of the population and so we never underwent the kind of lockdown that would really keep the virus in check. Basically, had COVID-19 been more deadly, and it already is significantly deadly, then the country would be forced to undergo the kind of procedures that would lead to a less drawn out recovery. Further, people would have taken it more seriously.
This is, I think, a key difference between MEV-1 in Contagion and COVID-19. MEV-1 is highly dangerous and everyone in the film seems thoroughly scared of it. Deaths happen swiftly and violently, the imagery in the film (seizures, etc.) really captures the terror of MEV-1. Thus everyone in the movie takes the virus very seriously and the country is forced to enact intense measures to overtake this. COVID-19 on the other hand is less straightforward. It’s dangerous, but the significantly more dangerous for certain populations. If you’re old, it’s terrifying (of course it’s been deeply politicized to the point there are even elderly populations that don’t take it seriously), but if you’re younger maybe it’s not that bad. Maybe you’ll feel ill or maybe you’ll experience more serious, long lasting complications. Or you’re in a vulnerable group where it doesn’t matter your age, it’s very dangerous for you. There’s a lot of variation. In essence, COVID-19 needs to fulfill certain conditions that determine how threatening it is. And its threat is determined at an individual level and the conditions that determine its danger vary. It’s a virus that lends itself to confusion and individually set rules. MEV-1 is straightforward. No matter your age or situation, you could die if you get this and should lock down. COVID-19 isn’t like this and I think the very nature of the virus lends itself to a population that views the virus with varying levels of fear, which leads to different behavioral responses across people. And this isn’t even getting into the way the virus has been deeply politicized.

Lastly, I want to briefly close with a discussion of selflessness. It’s something that I think our country deeply struggles with when it comes to the virus, particularly when it comes to abiding by mask-wearing or other procedures that keep us safe. In Contagion, there are several selfish characters featured, but the characters that are lauded and that we are supposed to admire/respect are the ones that are selfless. It’s a powerful message on the way humanity should approach a crisis like a pandemic. Erin Mears (Kate Winslet’s character) contracts MEV-1 and even in the midst of this horrifying realization, she still takes the initiative to call every person she came into contact with in her hotel and other places to let them know and check in if they’re okay. Dr. Ally Hextall (CDC) puts herself at risk by trying a test vaccine on herself, an act that I think is very moving in the movie. I think it’s clear how different selflessness has been across people in the US in reaction to COVID-19.

[atzavala]

The movie Contagion was disturbingly accurate to how many things unfolded during the COVID-19 pandemic. What I found the most interesting was the conspiracy theory vlogger who spread rumors about possible cures to the virus, as well as conspiracy against the CDC and the vaccines. This was not too far off from conspiracy theorists that felt the COVID-19 pandemic was not real. I remember seeing social media posts from conservative relatives who argued against wearing masks, as they saw it as a violation of their rights. And I even met an anti-mask individual a few months ago who claimed he wouldn’t get the vaccine because he didn’t want to be a “slave to this damn government.” Much like the man in the film, this paranoia and distrust towards government agencies makes crises like global pandemics difficult to maintain, and even more deadly as people do not take expert advice on how to keep yourself and your community safe and healthy. We have discussed in this class the spread of misinformation through social media, and how it has acted as a vehicle to spread these conspiracies and harmful ideas across the globe during such a vulnerable period like a pandemic, but I’d like to address why these ideas may be spreading like wildfire when there is clearly a bigger threat at hand. I took a class called the Language of Deception and Humor a year ago, and in that class we discussed why human beings are so prone to believing conspiracy theories. In a nutshell, our ability to believe such irrational beliefs like the Mandela Effect and Lizard People is because we have inherited psychological mechanisms that protect us from potential danger or life threatening situations. (Link) . It’s the “Better Safe than Sorry” way of thinking that allows us to believe extremely ridiculous conspiracies, and once these ideas are planted in our minds we tend to use confirmation bias to confirm these beliefs with unfounded evidence. People who believe that COVID-19 is a government hoax have convinced themselves that they are better off, and more safe believing that the virus is fake than letting the government brainwash them or have some unconstitutional control over them. Although I personally find the threat of a deadly virus much more dangerous, I’m sure the fear these people feel towards the unchecked government power seems completely rational to them given that they are probably consuming constant misinformation from social media. The increased anxiety, uncertainty, and fear for our safety in the last year coupled with the easy access to conspiracy theories and misinformation on social media in a time where most people in developed countries have smart phones and access to the internet seems to be the perfect storm and may help explain why the pandemic played out the way it did.

[brycefarabaugh]

risk #framing

The threat of human-developed pandemics and biological threats should be a major focus of policymakers moving forward, but the threat strikes me as less pressing than other existential risks given the seeming difficulty such diseases would have in totally wiping out humanity. To be sure, weaponized, human-developed pathogens could be catastrophic given recent advances in gene editing and the globalized world we find ourselves in today: for example, the Biological Weapons Convention, one of the most important international agreements governing such risks, has a smaller budget than an average McDonald’s restaurant, according to Toby Ord in “The Precipice”. On the other hand, the readings for this week highlight how even the worst pandemics throughout history have not threatened humanity’s survival, which leaves me somewhat hopeful given the severity of the threat..

For example, according to “Visualizing the History of Pandemics”, the pandemic with the highest death toll in recorded human history, the Black Death, killed 200 million people and wiped out 30-50% of Europe’s population, but such an event occurred when medical knowledge was practically non-existent (germ theory wasn’t developed until hundreds of years later.) Imagining such a deadly pandemic today, we can rely both on the incredible advances made in medicine (including vaccine technologies, as highlighted by the recent COVID-19 mRNA vaccines, as well as therapeutics that make deadly diseases like HIV survivable for most patients today) as well as knowledge about how to slow and stop transmission of illnesses. As can be seen in the CDC Community Mitigation Guidance from 2017, so-called “flattening the curve” has been a risk-reduction method supported by epidemiologists for years, one in which the general public has become intimately knowledgeable about over the past year and a half.

Additionally, were a much deadlier pandemic than COVID-19 to break out in the years ahead, people are already somewhat prepared with how to deal with it. This forced preparation is why some medical professionals have called the current situation with COVID-19 a “starter pandemic”, as relative death rates are still statistically low compared to other pandemics experienced throughout human history. In the event a much deadlier pandemic did surface in the years ahead, either through non-human animal to human transmission or through some type of lab disaster or biological attack, one can easily imagine governments around the world taking much more significant actions to stop transmission, which would likely produce even more effective results as people would also be much more concerned about getting infected by a disease with higher death rates.

Ultimately, while pandemics and biological threats are cause for concern, humanity can prepare for such threats given the current circumstances, and I would argue investing in such preparation in the short-term is bound to payoff for humanity in the long-term.

Below, "Participants of the 2019 BWC Meeting of States Parties" from the United Nations Office for Disarmament Affairs.

[vitosmolyak]

risk #salience

All of the content that the class was given for this week relating to pandemics made me think deeply about two things: 1. The pandemics of the past and 2. The pandemics of the future. The movie Contagion really hit close to home because in a 2-hour film it was able to summarize what life was like for all of us in 2020 and 2021. From the source of the outbreak to month-long periods of quarantine to vaccine rollout as depicted in the movie, we have actually lived through something that was portrayed in such a horrifying way. This was our lives. Though I have seen the movie prior to the Covid-19 pandemic, watching it again brought a lot of things into perspective for me. The movie was based on the number of pandemics that have occurred in the past while also almost perfectly imitating a pandemic that followed 9 years after the movies release.
With that said, I began to think about how humanity acted, reacted, and moved forward during pandemics prior to Covid-19. Specifically referring to The Spanish Flu, Smallpox, and Black Death, I assume that policy, vaccine rollout, and day-to-day life was very different and unfortunately more drastic than what we saw in the last 15 months. In addition, that can be attributed to lack of medical knowledge, technological advancements, and the role of media in society. As we saw, the severity of the pandemic had a lot to do with policy guidelines and the role of media (as we see with anti-mask vs mask debates online now and as we saw with Alan Krumwiede leading an "anti-vaxx" cult in Contagion). During the Spanish Flu, the world was not as small as it is now. In addition, vaccines could not have been rolled out as quickly and efficiently leading to a larger death toll. Does that mean that every subsequent pandemic will be less severe given newer resources and and increased amount of human knowledge? This made me think about how the next pandemic will play out. The graphic I am attaching shows that the amount of pandemics that we see in history are increasing exponentially. This indicates that we will likely see another infectious outbreak in our lifetimes that will be deemed a pandemic. I am curious how politics, media, technology, and other aspects will affect how we face the next pandemic. In addition, it will be extremely interesting how policy will change after the current pandemic is over.

[ydeng117]

pandemic #framing #risk

The issue of pandemic presents us a paradox about our current democratic system. If we consider the society as a whole, each individual would be a single cell for the social body. Our democratic system respects us as independent individuals and grants us the freedom we agree based on our social contract. However, when sudden crisis happen and require us to synchronize and collaborate, how should we draw the boundary between personal independence and collective responsibility? The on-going pandemic of COVID-19 has demonstrated how vulnerable our social body is when each social cell cannot reach a consensus on the intervention of the pandemic. In other words, our current democratic social system is too liberal to deal with an infectious disease. As the guidelines to prevent pandemic influenza points put, the nonpharmaceutical interventions require people to realize their social responsibility to protect others from being infected with the disease. Taking responsibility requires people to form new social contracts and usually means sacrificing some degree of self-independence. If we cannot follow the new rules and make such sacrifice, should the government do the job? As a Chinese student, I had witnessed the total lockdown of city and experienced the force quarantine in China. To be honest, it did not feel well to be locked in a hotel room for two weeks. Nonetheless, I felt safe after my quarantine ended, as I know other people in this country also have to follow the forced pandemic prevention policies. I, as a single cell in the society, shared the same burden of preventing the pandemic with the rest of 14 billion citizens in my country. Maybe the lesson for the current COVID-19 pandemic is that we should acknowledge that we are not saints. As a single cell for the social body, we probably need a powerful and determined brain, the government, to play the cerebral role in regulation. Of course, we are afraid of being ruled under the tyranny, but we should realize our responsibility to protect our society from social chaos and deaths.

[nikereid]

risk #salience

The movie Contagion shows us a what life during this pandemic may have looked like had the Covid-19 virus been as deadly as some plagues humans have seen in the past. Despite the large difference in mortality rate between Covid and the virus in Contagion, there were many similarities in the lives of the main characters in the movie and our lives during the pandemic. For a film that came out nearly ten years before the onset of the pandemic I found the portrayal of how a pandemic affects the entire planet to be surprisingly accurate. The film did seem a bit unrealistic in that the virus was far more transmittable, deadly, and mutative than any of the five recent global disease breakouts we have seen (SARS, Swine, MERS, and Ebola). My guess is that such a deadly disease outbreak is extremely unlikely, especially in today’s age with our technology and knowledge from prior experiences. I’d like to think that after a year-long global pandemic we are more prepared for the challenge the next time so we can properly mitigate the spread of the virus in order to effectively reduce lockdown times and see minimal impacts to our global economy and health.

Between global climate change, nuclear fallout, misaligned AI, and a global pandemic, I can confidently say that I’m least worried about the threat of a pandemic. Although every nation responded in their own way, I do feel like it was somewhat of a collaborative process across the world. Some countries were able to defend themselves better than others obviously, but for the most part I think the majority of us, as humans, did well to protect each other from the virus. Not only do I think our experiences from the past year will help us come another pandemic, I think the experience of communicating and acting independently on a global scale will contribute to our ability to deal with other existential threats in the future as a unified entity.

[gracecwagner]

framing #salience

Here’s a hot take for you: The US wasn’t as unprepared for the Covid-19 pandemic as you think.

Here’s what I mean by that: The US government under Trump? Sorely unprepared, scrambling to implement (Were they really though?) policies and regulations after the virus was spreading, and questioning the science and legitimacy of the threat the entire time. Even as the leadership was warned of the severity and advised to take early action, the encroaching pandemic was ignored.

The people of the United State, I think, dealt with the pandemic much better. (Most) People accepted the lockdown and did their best to stay home to curb infection rates. Lots of vocal support was heard for the front-line workers that kept essential businesses like hospitals and grocery stores running (even if the material support wasn’t/isn’t what it should be). (Most) people wear masks. (I’m choosing to look at the bright side please don’t @ me I know there are people who aren’t, and the US is FAR from perfect (literally so far))

While the public did their part to curb infection rates, there was a starting place to find a vaccine, with information from research into SARS and other similar coronaviruses gave scientists a jumping off point.

The new administration has been pushing for as many people to get the vaccine as possible, creating a new wave of pro-vaccine science and pushing for vaccines for all people who can safely get one.

The United States government was not prepared, but the United States was.

Now that the United States has made it through the deep end (fingers crossed), we need to do our part to help other countries like India get through it. This isn’t to say that India’s people weren’t prepared (no one really was, it was more like we already had bits and pieces of the puzzle). The US went through multiple spikes. But now that there is a vaccine, the final piece of the puzzle needs to be shared with everyone.

[dnaples]

movie #risk #salience

La Jetée is a film I was somewhat surprised to see in the category of our Pandemic week. While it makes sense in combination with the film it inspired (12 Monkeys), on it's own La Jetée seems to solely tell a story of time travel in a post war apocalyptic world. However, while re-watching the film there were moments that almost seemed to parallel the public's approaches to the handling of COVID-19.

The story of La Jetée is about a prisoner forced into time travel by captors hoping to rescue the devastated present by seeking help from the future. The main character first takes several experimental trips to the past, where he gradually falls in love with a woman in that time period. Eventually, his captors no longer send him to the past, but to the future for resources. He completes his mission, but is now expendable to his captors, who plan to kill him. The main character is offered protection in the future by those he made contact with, yet instead, he chooses to return to the past, to his love, and to his old ways. This course of action is surprisingly similar to the way a lot of the public (at least in the United States) approached living with the COVID-19 pandemic. Throughout the pandemic we saw several cases of people ignoring CDC guidelines and even having mass gatherings in spite of the severity of the disease. In this way, many people were just like the main character of La Jetée, in the sense that they had no desire to look to the future of coexisting with a deadly pandemic, and would rather return to their past where these concerns of the present never had a grip over their lives. In La Jetée, the main character's fixation on the past ultimately leads to his downfall.

The main character of the film is not the only one that cannot except their present reality. I find it interesting that not only the prisoners, but those in control also seem to share the same sentiment of wanting to escape their present. Rather than finding current solutions they decide to look to the future and past instead. In a way, this is comparable to the manner in which some governments and officials handle our current pandemic, especially in the United States. For example, while all these restrictions were put in place for COVID-19, there were several instances in which they were not enforced or lifted prematurely (take the opening of public spaces for example).

I think it's also interesting to consider the film's approach to the future. In La Jetée's present day, Paris is in shambles, and radioactivity from a nuclear war has made the surface of the city inhabitable. Yet when our main character travels to the future, humanity seems to have prevailed and become even more advanced, having rebuilt Paris even bigger, and having "transformed the world." While not intentionally, this says a lot about the mindset of humanity, as in it doesn't always see itself coming to an end, and choses to depict a happy ending for itself, when in reality, this may not be the case.

While La Jetée is a work of fiction, it is surprising how much it mimics the behavior of humanity in situations of existential crisis.
The film may not best represent the reality of these crises, as solutions are easily attained by escaping the present, but throughout La Jetée humanity does not seem to accept their place in current realities, paralleling the lack of seriousness taken toward some current existential threats, including pandemics.

[cjcampo]

policy #solutions

"Our Commission strongly believes that one federal department cannot tell other departments and agencies what to do, especially in a critical area of responsibility like biodefense. The stalled execution of the National Biodefense Strategy demonstrates what we believed to be true: only the White House can direct all parts of the federal government to work together to defend the Nation against biological threats. Direction must come from someone occupying a position with the imprimatur of the President and the authority to act on the President’s behalf."

This post is inspired by the above excerpt from this week's reading Biodefense in Crisis. It's actually also inspired by my friend Alex Azar, a fourth-year at the University of Chicago, who shares a name with the former Secretary of Human and Health Services in the United States.

Explicitly, I'd like to dig into the delegation of responsibilities with regards to handling pandemic response in the United States. Early on in the pandemic, it became clear to me that the invocation of states' rights would dampen attempts of the federal government to "flatten the curve" and "slow the spread" of the virus. I'm originally from North Florida, which is essentially the south, and the difference between general sentiment towards the pandemic and also actual municipal/state policies in Gainesville vs. Chicago was quite jaw-dropping.

We all know that ordinances for masks, travel restrictions, restaurant and bar restrictions, and curfews are dealt with on a state and municipal basis. But what's more confusing is the policy and signaling from the federal government: the excerpt from the piece above urges the White House to swiftly and soundly direct pandemic response. In reality, a whole slew of federal agencies have their hands in the mix, and the White House does very little in actual implementation of disease control. The importance of this statement, while maybe not immediately obvious, comes into light if you consider the Trump vs. Fauci framing that was perpetuated by both the White House and the media, and wasn't really a farce if you consider the differences in what each side was telling the public. In short, I interpret the section as calling on the White House to make decisions and disseminate information that is consistent with the opinions of the federal agencies who are delegated to implement specific policies and ordinances in different areas.

This is all very vague, but it's really a statement about consistency across departments or branches at the upper levels of federal government. In turn, it's actually a statement about misinformation campaigns rather than one specifically about public health. But, to make this more tangible in terms of the delegation across agencies and branches of government, I'll state some important responsibilities that each has during the pandemic. All of the following information can be found here.

• Congress generally has the responsibility to apportion funds for public use and for response to public emergencies, but can also choose to delegate such funding decisions to the White House. Otherwise, they can also pass laws (such as easing restrictions for medical testing) to aid the private sector response to the pandemic.
• The executive branch's response is either dictated by congress or, if not, by the agencies with proper jurisdiction over certain issues. The president may also interfere by way of executive order. Of course, the aforementioned jurisdictions are often cloudy--for example, COVID-19 vaccines have implications for the FDA, CDC, and HHS, among others. One important thing, and perhaps the purpose of this post, is that even in cases where the president isn't involved in agency policymaking, their opinion can be highly influential in public understanding and acceptance of such policies
• The courts are involved, on both a federal and district level, throughout the entire totem pole

It's worthwhile to question the split between the federal government and states/municipalities in responses to the pandemic, particularly when considering the early success of federally-imposed shutdowns in countries with more authoritative central governments. But, before relying further on the federal government to make decisions for us, it is imperative that the White House acts in good faith for the health of the country, and in-step with its peers in the executive branch.

[LanceJohnson1]

data #origin #policy

Unlike some of my memos from prior weeks, which focused on a unifying theme across the readings, I would like to instead focus on developing 2 thoughts of mine from my favorite reading ("History of Pandemics") that I think are particularly worth expanding upon.

I will start with the article on the "History of Pandemics." Though this article was useful as a brief overview of global pandemics, I would be remiss if I did not question the comparability of the data cited in the chart summarizing the death toll for the most deadly pandemics in history (Figure 1 Below). Though the data would lead a reader to believe that from both a nominal and percentage basis, COVID-19 is significantly less deadly than countless other viruses and diseases, no comment is made on the confounding modern vaccine technology and widespread distributional capabilities. I think the article would have been better served citing hospitalization equivalent metrics to adjust for the asymmetrically effective medical attention received in the more recent outbreaks. I do give them credit for succinctly displaying the R0 from these various pandemics, a more telling metric, however.

The 2nd more high-level thought that I had after reading this article was just how lucky the world is to have coincidentally developed the groundwork behind mRNA vaccine technology the past few years. The crazy thing is, after doing more research on this technology, Katalin Karikó spent the 1990s collecting rejections in her work attempting to harness mRNA to fight disease in humans - she was outcasted by government grant and corporate funding programs, and she even lost much of the respect of her colleagues. In 1995 she had been on the path to full professorship at the University of Pennsylvania, but got demoted as the tenured professors within her field at the school thought she was traveling down a rabbit hole. The vast majority of people would have given up, but instead, Karikó spent the next decade of her life building better experiments through trial and error. Without her persistence, there is no telling whether or not mRNA technology would be where it is today! Putting this aside, imagine if COVID-19 came in the early 2000s when this technology was in its infancy!

Pandemics, as depicted in “Contagion,” highlight how rising global connectivity, rampant nominal population growth and subsequent compression of animals’ living spaces culminate in lethal and highly contagious viruses / diseases. One of the topics that I hope we get a moment to discuss with Suzet is her thoughts on how likely it is that COVID-19 is only the tip of the iceberg in the decades to come.

One of the things we have spent a lot of time in class discussing is how policy can be used as a means of enacting change. In a memo I wrote several weeks ago, I mentioned how policymakers are more reactive than proactive with their budget allocations. As seen in Figure 2 below, COVID-19 has instilled a powerful justification for vast increases in spend in the pandemic prevention space. The proverbial risk-reward should be self-explanatory to policymakers globally with this chart alone.

Figure 1:

Figure 2: `

[shiruan-uchicago]

framing #critique

One of the major advantages of human being in face of pandemics is that we have an international organization, the WHO, with the functionality of resource coordination and worldwide mobilization, as well as the credibility of being impartial and science-oriented. The film Contagion (2011) also exalted the role and character of the WHO. However, the performance of the WHO has been less ideal since the COVID-19 pandemic. Indeed the WHO is a non-government organization with limited fiscal and coercive power compared to states and thus (sometimes) inevitably vulnerable to political pressure and non-cooperation from the latter, such as Trump administration and Chinese government. Such shortcoming is structural and, as the Independent Panel for Pandemic Preparedness and Response (IPPPR) established by the WHO pointed out in its most recent report, can and should be tackled via systematic reforms of expanding the political and fiscal power of the WHO and making it truly independent from outside influence. Despite its innate structural deficiency, the WHO’s responses at the beginning of the pandemic were also problematic. For instance, its senior officials repeatedly claimed in March, 2020 that “there is no specific evidence to suggest that the wearing of masks by the mass population has any potential benefit”(see COVID-19 - virtual press conference - 30 March 2020). It didn’t update the mask-wearing guidance until June. It is understandable that the organization wanted to prioritize the use of PPEs for medical workers in case of a massive shortage as happened in China. However, the way in which the WHO refuted the benefit of mask-wearing for the public was arbitrary and not fact-based – studies had shown that respiratory droplet transmission of the COVID was likely to be reduced by wearing masks. Such statements further created a sense of uncertainty among the public, had negative impacts on relevant policy-making aiming to enforce mask-wearing and social distancing, and fuelled the anti-mask conspiracy theory. As the IPPPR report said, the combined response of the WHO and global governments was a "toxic cocktail". And certainly the combination of structural and temporary failures of the WHO contributed to the 21st Century's "Chernobyl moment".

The main report of the IPPPR was released today (May 12). I personally don’t believe that the COVID-19 will be the last pandemic of human being. But I think that the WHO and global governments can do a better job when another pandemic occurs if they take meaningful measures according to the report.
https://theindependentpanel.org/mainreport/

[WinstonHartnett]

framing #policy

Having watched Contagion and the last few months of American pandemic-politics, it's clear that the "solution" to new pandemics diseases isn't a miracle drug or dedicated, well-oiled contact-tracing structure, or even preventative human-animal separation (i.e. preventing crossover events by limiting contact with animal populations). For much of the world, especially in fast-growing and underdeveloped regions like in the gulf of Guinea, central Africa, or SEA, these measures will be out of reach for the foreseeable future at a time when there is greater human-animal contact as a result of climate change. Deforestation, one of the leading causes in habitat loss, really means "survival" for much of the world's poorest poor to cook meals and heat homes. Likewise, hunting wild game and/or livestock are the only ways to supplement chronically unstable food supplies in developing countries.

This presents a climate-change-like challenge to the West, where the economic fortunes of countries beyond the confines of the developed world are deeply linked to not only the likelihood of pandemic disease to emerge but also their ability to contain it quickly. In concrete terms, it's multilateral agencies like the WHO and World Bank that the developed world expects to slap a bandaid on pandemics while never being given enough agency to coordinate and quash their causes. Many publications have noted that the WHO, as the leading world health body, often strains to both be a global standards (i.e. controlled substances, drug safety, disease classification, etc.) and firefighting (i.e. control pandemics, eradicate disease, etc.) institution, due to lack of funding (nearly 25% of its budget comes from non-state actors) and competing "jurisdiction" with other "non-state actors" like Médecins Sans Frontières and the Bill and Melinda Gates Foundation. This leads to duplicated effort, uncoordinated responses to global health crises, and a less-proactive and defensive attitude on a global scale.

If the world wants to get serious about global health, it needs a concrete and coordinated response to the economic plight of the poorest through measures like electrification (only 48% of Africa has access to electricity---although it is growing), technical agricultural aid (not just food aid), and access to basic sanitation. However, the developed world also needs to acknowledge that global health crises have global impacts. As we've seen recently, less than 10% of India and almost none of Africa has been vaccinated against COVID, allowing for potent COVID variants to take hold and threaten all countries. The WHO's Covax program has proved incapable of securing enough supply. Therefore, as public health becomes global, it's essential that the developed world treat is as such and guarantee substantial funding for the WHO, devolve some of their national regulatory powers to international organizations to streamline new treatments, and, most importantly, work towards establishing capable international organs that can effectively redistribute global wealth and ensure access to life-saving technologies (like treatment patents).

[meghanlong]

pandemic #salience

Coming from Dr. Fauci, a quote like "We remain at risk for the foreseeable future," seems commonplace [1]. This isn't just being made in reference to the risk of getting or transmitting COVID-19; this is in reference to the fact that in our lifetimes, it is extremely likely that our generation will be responsible for navigating society through yet another global pandemic (or multiple).

Undoubtedly, US leaders made a barrage of massive mistakes in terms of responding to COVID-19 quickly and effectively, thereby worsening the spread of the virus and hampering the US population for months to come. While part of this poor response can absolutely be blamed on the Trump administration's lack of care and lack emphasis placed on science and fact, I believe that part of what spurred this failure was the longstanding idea that pandemics are unlikely, surrealist events that happen only in third world countries which can't afford to provide medical care and assistance required to treat the disease at hand.

Since 2003, federal spending on resources that would help protect the US against a potential pandemic have fallen steadily under every single administration- both Republican and Democrat [2]. Had we not lived through 2020, this decision would not have garnered a single comment or glance- after all, pandemics seemed (at least to me) to be incredibly unlikely- a figment of the Hollywood imagination, like widespread nuclear war, robot invasions, or extraterrestrial life.

When you search around online for the likelihood of a pandemic occurring, every top article provides a lot of words, but very few numbers, and zero percentage predictions. The consensus on the internet seems to be that pandemics have a return period of approximately 100 years. They are a once per century event, and while we were unlucky to have a year of our lives wasted as a result of this one, we likely won't be around to live through the next. We need to snap out of it. This is not a once-every-100-years event anymore.

If you take the pandemics listed in the graphic below, calculate the time between the start of each one, and average them, you will find that on average, we see a new major pandemic every 97.58 years. The internet wasn't far off. However, the internet also falls prey to a classic math mistake; the average is not representative. It doesn't actually tell us much. If one looks beyond the average, things get far, far more concerning, and people aren't talking about this enough.

Beginning in the 100s, there were a few hundred years between each major pandemic. By the time we get to the 1600s, it is down to 100 years or less. 1850s and beyond under 50 years; 1900s and beyond 25. In the past 10 years (2009 and beyond), there have been less than 5 years between each major global pandemic. The number to discuss here isn't 97.58 years or 100 years; it's 4.25. That's the 10-year average return period for a pandemic; 4.25 years. It's time to start using real numbers that better describe the current state of the globe, and better reflect the real risk to humanity. When will the return period drop to 1 year? A month? When that happens, what do we do?

[1]. https://www.infectioncontroltoday.com/view/ready-for-the-next-pandemic-spoiler-alert-it-s-coming- [2]. https://www.politifact.com/article/2020/mar/30/federal-pandemic-money-fell-years-trumps-budgets-d/ Image: [3]. https://www.visualcapitalist.com/history-of-pandemics-deadliest/

[ChivLiu]

origin #policy

Last year, when COVID-19 first outbroke in China, the US immediately shut down the border between the US and China. No one would expect that the pandemic could have gone so crazily as it is today during that period. The US government blamed China very frequently for "hiding stats" and "creating virus". Undoubtedly, under the background of the government-led Trade War and the requirements for earning more campaign supporters, the White House and the former president had to release the pressure to other places and form a media environment that benefited them. However, while COVID-19 finally arrived in the US through European visitors, the White House totally lost its minds and refused to take immediate action. The former president spent most of his efforts creating fake news and spreading the hate against Chinese Americans by using the expression “Chinese virus” more than 20 times between March 16 and March 30. He downplayed the likely consequences of the coronavirus, presenting it as a minor nuisance and exaggerating the federal government’s response. Moreover, he never tried to help the black people earn their comforts after their parades and help them improve their living conditions. On the other hand, China held very successful policies against the pandemic and opened the gates of Wuhan after tough losses. The government spent billions to help the people and help small businesses to survive. China's strategy is to reduce the number of flights nationwide and implement strict border quarantine measures (quarantine + nucleic acid testing) in major cities. It resulted in contemporary economic declination, but nowadays, it has been considered the most remarkable control of the disease. The Chinese government and municipal governments' border control and quarantine measures are appropriate in intensity and time. Without completely blocking traffic, the spread of the virus was controlled in a timely and effective manner, avoiding a large number of infections and deaths.

Sources: https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0008908 https://www.theguardian.com/us-news/2020/oct/02/prayers-and-criticism-as-public-figures-react-to-trump-covid-news-coronavirus https://theconversation.com/donald-trumps-chinese-virus-the-politics-of-naming-136796

[smichel11]

risk

NOTE: This is not for my movie submission. I am using Contagion as if it were a reading.

If I am completely honest, watching Contagion made me very anxious, especially given the current COVID-19 pandemic. Watching the movie's virus quickly spread, infect, and kill a large chunk of the world's population was awful and almost impossible to watch. There were so many similarities to the current situation. Jude Law's character echos many of the conspiracy theorists promoting sham cures like hydroxychloroquine--which some lawmakers like Brazil's president Bolsonero actually endorsed--that endangered so many lives. The social distancing, the general confusion, the panic--these are all things we have seen and lived before.

But something I couldn't help but think: if our response to a less-deadly virus has been poor, then what the heck is the world going to look like if something as deadly (god forbid) as the Contagion virus were to appear? We were having violent riots and chaos without it being a virus with a 20% to 30% death rate. Misinformation has spread like wildfire, leading to the slowing of the vaccine rollout because people are refusing to take it. Hope for herd immunity is in jeopardy because we will not be able to reach the amount of vaccinations needed at this rate. If something much worse than COVID-19 were to break out, as it stands right now, we would be screwed.

That's something that is terrifying about this existential threat. Throughout all the readings, you realize just how helpless we are to the spread of diseases. Sure, there are some preventative measures you can take, but at the end of the day, there is little we can do to stop it--people will get sick. Especially with increased globalization, shrinking water sources and animal habitats, and worse living conditions (the latter two both to do with Climate Change), another pandemic is bound to happen, and we have no idea when. I think something with the other threats is that I feel like we can actively see the problem and come up with tangible, achievable results that we know can stop these existential threats from occurring. We can come up with nuclear legislation and disarm bombs. We can invest in clean energy and care for our planet to reduce (and maybe even reverse) the effects of Climate Change. We can work towards building a more equitable future and increase civil rights. And while we may be able to put things in place to help prepare for a future pandemic, unlike the other threats, there is nothing we can do to stop it from ever happening. I just hope that next time, we are more prepared.

[dramlochun]

origins #policy #solutions

This week, while reading the Biodefense in Crisis recommendations, I couldn’t help but think of one glaring omission. The article praised U.S. vaccine innovation and distribution, but it failed to acknowledge a recent discussion spearheaded by the Biden administration surrounding Covid-19 vaccine waivers. This has become a point of contention as the U.S. and other Western countries enter a period of full recovery from the pandemic, with large percentages of the population fully vaccinated, while developing countries like India are facing their roughest stretch yet. Today, India, with over 300,000 new cases each day, accounts for approximately half of the entire world’s reported cases. One significant factor without a doubt has been a low vaccination rate, with just 2.7% of its population fully vaccinated – far behind the U.S. for example at 35.5% and the world average at 4.2%. This is especially troubling and perplexing given that India has long been one of the world’s largest and cheapest manufacturers of vaccines. It has been clear that India has fallen behind, and the reasons for this are worth examining and exploring solution for to prepare for future pandemics.

One major barrier that the Biden administration hoped to eliminate was patents on U.S. Covid-19 vaccines and legal barriers preventing the necessary materials to manufacture U.S. vaccines being exported to India. Under pressure to provide solutions to the raging crisis in India, the Biden administration enacted these measured in order to allow Indian vaccine manufacturers like SII to begin manufacturing new vaccines. However, a brief analysis of the timeline of events shows that the real issue isn’t access to intellectual property, but instead a lack of regulation of corporate behavior.

Prior to this, India had been manufacturing primarily the AstraZeneca vaccine, and had been exporting millions of dollars’ worth of the vaccine since 2020 to other countries. Before the recent surge, India had seen a large number of cases, but manageable enough that the country felt that exporting most of its vaccine supply abroad would not be an issue. Even in February 2021, when cases began to spike, India still exported over 30 million doses. In March and April, it became clear that India desperately needed 100s of millions of doses, and suddenly, SII claimed it needed 403 million dollars to increase capacity and was charging significantly above cost for a profit – making India one of the most expensive places in the world to find a Covid-19 vaccine. Moreover, SII claimed publicly that it would only export vaccines to low-income countries desperately in need, but in March millions of doses were still going to Western countries like the U.K. for example due to higher profit margins.

In the end, this has led India to a crossroads, with one option to prevent all exports of vaccines. Another, to ask manufacturers like SII to share licenses from other countries to manufacture other vaccines. More importantly, in the future, it is evident that in times of crisis, equity is more important than corporate profits, and perhaps manufacturers should not be permitted to selectively export vaccines to countries willing to pay the most. Lastly, in times of need, these manufacturers in developing countries like India must be encouraged to share licenses to manufacture vaccines, such that India need not find itself in its current situation with just SII controlling much of the vaccine supply. What we’ve seen, is a clear inequity in access to vaccines as a result of this behavior, with just 0.3% of the world’s vaccines administered in low-income countries.

Sources: https://qz.com/2004650/why-does-india-have-a-covid-19-vaccine-shortage/ https://www.cnbc.com/2021/05/12/india-covid-crisis-who-says-it-accounts-for-50percent-of-reported-cases-last-week.html https://www.nytimes.com/2021/04/25/world/us-vaccines-india-covid.html https://www.cnbc.com/2021/05/10/covid-vaccine-patents-eu-doubtful-of-us-plan-to-waive-ip-rights.html

[dillanprasad]

framing

In 2019, I recall seeing a thought-provoking article in the Journal. The article discussed pharmaceutical companies, superbugs, and basic incentives. In order to fully explain what I believe will happen in the coming decades and why, some brief context is needed.

Pharmaceutical companies either manufacture drugs and vaccines or they purchase the intellectual property/associated patents to do so. However, the average research and development cost for a new, FDA approved drug in the USA is approximately $1 billion USD. Thus, only very large pharmaceutical giants are actively engaged in the development, production, and approval of original drugs designed for the public market.

In recent years, we have seen a concerning rise in resistant variants of common bacterial or viral pathogens. This spike is thought to be attributed largely to the forces of evolution, as humanity's over-usage of antibiotics during the past 70 years has exerted selective pressure on pathogenic infections to the point of mutation; this mutation, in some cases, can be advantageous. Some "superbugs" have mutated to the point of antibiotic resistance; our modern antibiotics are less effective or ineffective against treating them. It has been long thought by scientists that diseases with true, "pandemic potential" are those that exhibit resistance, have an intermediate incubation period, and are highly contagious.

This brings us back to the pharmaceutical industry. It has become increasingly expensive for pharmaceutical companies to develop drugs that are effective against antibiotically-resistant diseases; pharma companies develop drugs, with a massive research and development price tag, with the aim of making them profitable in the long term. However, the much needed drugs that fight superbugs that could "potentially" become a problem in the future are risky investments. Companies run the risk of losing billions in investment for no real profitization. Thus, this article--which left a lasting impression on me--discussed that most pharma companies have, in fact, stopped funding specific drugs to combat unknown future threats at all. This obviously leaves us with a great deal of uncertainty; imagine if one year, a variant of a common condition ended up being lethal? We would have little to do about it.

[seankoons]

How did America lose to COVID? How did the pandemic affect our way of life? As one of the most powerful countries in the world, we had a response which led us to being the number one ranked country for worst response to COVID, just above Brazil and India according to an article on Move Hub. The refusal to act that came from our 45th president was one of the main causes of our defeat. With someone who didn’t believe the virus was real, who then got the virus and survived and made it look like no big deal, and who was crowed as a superhero afterwards, controlling the course of our country, it seems like the last year in COVID came straight from a movie. The United States’ initial response to the outbreak was to not listen to what other World Health Organizations were advising, such as disease tracking systems and wearing masks. The CDC at first recommended not wearing masks, and as anyone today can see, that’s definitely not what their advice has been for the last year.

How did other countries compare? Taiwan led as the top response country, followed by New Zealand and Iceland. So, what did they do that we, the United States, could’ve done? Even before the pandemic was apparent to most countries, Taiwan was prepared. They had facilities set up to trace and test people, and labs with enough space to examine everyone’s tests. Similar to what we talked about last week or the week before, they were ready because they planned for existential risks. Their country and their country’s government were prepared for this sort of problem to arise; being so close to China, they were already testing people coming from Wuhan before the pandemic started. New Zealand, in January of 2020, set up a National Health Coordination Centre and started an elimination plan that was used to completely eradicate the virus from the island. The United States did not do any of those things. No travel bans were place, or were at least effective, and did not start this pandemic with any sort of plan of action.

All these poor choices made by the United States led to people’s ways of life changing. For some time, we couldn’t go out to restaurants, take walks for fun and enjoy the park in groups of people, go to parties, hangout in cafes, not have to wear a mask when walking ten feet to the bathroom in your dorm, and so many more things.

If the United States learned anything from this pandemic, it should be that we need to prepare for the worst. Now that this virus has shined the light of a pandemic reality into eyes, we need to be ready for when it happens again. That means no mask and hand sanitizer shortages, open and ready testing facilities and labs, and a government that is ready to respond.

[starmz123]

risk #solutions #salience

Biodefense in Crisis is a holistic overview of the different areas in which improvements must be made to better prepare the U.S, and the world, for the next biothreat. However, one crucial element that is missing from the report is inequality. As COVID-19 has shown us, inequality both on a domestic and global scale has threatened humanity's ability to suppress this global pandemic. Given the current trajectory of increasing globalisation, it seems like redressing these inequalities may become ever more important in construction our biodefenses.

National disparities have manifested both in the impact of and response to COVID-19. The latter is more relevant for biodefense: a successful strategy must be able to respond quickly and comprehensively to an outbreak, and unfortunately, racial inequity persists in vaccination rates. This could be linked to disparities in public health infrastructure, such as the lower density of vaccination sites in majority-minority neighborhoods. With such disparities, reaching herd immunity seems far-off for the U.S. This is an important qualifier for Recommendation 15, "Provide emergency service providers with the resources they need to keep themselves and their families safe." Even if all service providers were provided the necessary resources, the response would not protect the entire nation if providers are not sufficiently distributed. Inequity does not only impact the specific neighborhoods experiencing underinvestment—it impacts surrounding areas and the rest of the nation, because a biothreat does not care about geographical or socioeconomic lines. To truly develop a robust biodefense strategy, America must simultaneously invest in developing and supporting equitable public health infrastructure (e.g. facilities for service providers).

Throughout Biodefense in Crisis, the authors note the importance of global coordination and collaboration. Again, however, they do not explicitly emphasize the role of inequality in biosecurity. India's current crisis is not only a national emergency but also a health and economic threat to its neighbors. Similar to how inequity in the U.S. threatens the nation's ability to reach herd immunity, inequity worldwide is threatening humanity's ability to overcome COVID-19. The global inequality in vaccine distribution and case fatalities is staggering—while the U.S. plans to open up by the end of 2021, almost 130 countries haven't even begun vaccinating their populations. Although the U.S. has implemented travel bans, they don't cover a majority of the world and it seems unsustainable to increase travel restrictions. If anything, it seems likely that these restrictions will lift as the U.S. opens up. Yet, many of the world's most populated places could be actively addressing COVID-19 until 2023. This inequality leaves even privileged places like the U.S. in a dilemma, particularly when combined with the decreasing probability of herd immunity. Does the U.S. restrict travel for years, while the rest of the world catches up, or does it return to business as usual? And what about the potential for COVID-19 to [increase inequality](https://www.imf.org/external/pubs/ft/fandd/2020/09/COVID19-and-global-inequality-joseph-stiglitz.htm)?

There is a third way. The U.S., and nations that are similarly better-off, could contribute more to global COVID-19 efforts while working on health equity domestically. As global society comes out of the pandemic, governments must work harder to form international collaborations around resource access. Global medical access has always been deeply unequal and COVID-19 has shown us how urgently we must change that. When it comes to public health, humanity is only as strong as its weakest links.

[Brunofireflame]

risk Just recently the CDC pandemic guidelines have been updated - recommending that all vaccinated individuals can perform indoor and outdoor activities maskless. Some are saying that this will mark the end of an era, while others are saying that they'll remain masked for a long time on. Which is correct? I think both have merit:

All Americans have had to change their lifestyle due to COVID, giving up "non-essential" things such as seeing friends, or going to the movies. According to the updated guidelines, we could do that again. As a first year college student, I for one am happy to see this as a sign that my second year will be in-person, on campus, with little to no COVID restrictions. And even though many social traditions are frivolous and unnecessary (and hopefully these never come back), most of them are not. 2020 was one of, if not the most damaging year to people's mental health. From a lack of socializing, to working from home, to the bleak outlook of the pandemic, it was not a good year. With the updated restrictions, hopefully this will begin to ameliorate.

On the other hand, most Americans know someone who has died of COVID. Many Americans have had several loved ones taken from them by the pandemic. To just get up and move on so suddenly feels very difficult, and there's always the worry that maybe the CDC is wrong. Maybe one of the variants is vaccine-resistant, and by going out we will all get it, and that leaves us in a worse place than where we started. There may not be any sort of evidence for it, but considering the endless terror that the pandemic has inflicted upon us, it is very understandable that people have this concern. Wearing a mask has become a feeling of safety, that we are helping our fellow Americans out by wearing it. To not wear a mask means that you are putting yourself out there, and nobody wants to be the one that gave their friend COVID. And, scientifically, wearing masks has been good for more than just covid. 2020 was (ironically) one of the best flu seasons in terms of cases. Although COVID was tearing through the nation, a perennial disease was nearly nullified by mask wearing. So what do we do? Do we tear off our masks, give everyone we've missed a hug? Or do we continue to take caution in our actions, and wait until things are well and truly safe? What does it mean to be safe in a public world? I don't really have an answer, but I think it's important to think about.

[Aiden-Reynolds]

Framing #Salience #Policy

The biggest issue that can be seen from this week's readings as well as our own experience with the pandemic is that there is no global political body currently capable of handling a threat on this scale. Throughout the pandemic the global community has essentially failed to act in unison with any common purpose. This has resulted in the Covid-19 pandemic spreading to the entire globe, while each country successively tries to handle their own Covid crisis. Currently the national scale seems to be the largest scale at which any solution to a crisis can be effectively implemented. While the Covid-19 pandemic is not an existential crisis, it can serve as a valuable trial of our capabilities for dealing with more deadly pandemics in the future, a trial which we for the most part have failed. The pandemic is still raging in several of the largest countries around the world and shows no sign of stopping any time soon. Countries around the world are stockpiling vaccines and cutting off support from each other while military activity has not slowed down at all. As has been shown throughout this, there is no international body with enough power or influence to organize nations around the world into a unified response. Even disaster movies like contagion actually overestimate our ability to respond to a crisis on this scale. This forces us to come to the conclusion that if a far deadlier pandemic emerges in the future, we will fail to stop it on a global scale. Some nations may be able to organize their own responses and make it through such a pandemic, but the vast majority of communities around the world will not be. Because of this fact, an actual existential pandemic will almost certainly do an immeasurable amount of damage to human civilization on this planet as only a few nations may make it through with limited hardship. Without a dramatic change to our international political system and the formation of a body with enough centralized power to organize every nation and implement a solution on a global scale, we will find ourselves unprepared for the next pandemic.