Future Scenarios for Emerging Infectious Diseases

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Sohail Inatullah [1]:

"Based on the hundreds of articles, we see at least four possible futures.

1. Zombie Apocalypse (CDC 2020)

" This future emerges because of the mutation of the virus plus xenophobia plus panic. Uncertainty leads to continued market crashes. Supply chains, tourism, travel, and conferences are all disrupted. A severe and long term recession, if not depression, results. Failure to act leads to a number of regime changes, as in Iran and the USA, to begin with. Wherever there are system stresses, they break. This is certainly how the future feels to many. The memory of earlier plagues remains at the inter-generational level. Fear and panic rule.

See: https://www.cdc.gov/cpr/zombie/00_images/header-index.jpgImage from https://www.cdc.gov/cpr/zombie/index.htm

2. The Needed Pause

Efforts are made in most countries to ‘flatten the curve’ to help health systems cope. In the future, COVID-19 becomes just another winter flu – dangerous as it is for the elderly and those who smoke. It is, however, solved and routinized within a year. Big Pharma sees the money-making opportunity and by 2021 a vaccine is available. In the meantime, the frenetic pace of everything slows down, with multiple benefits to the planet and personal health. Greenhouse gas emissions fall, for starters. Over-touristed cities like Venice get a break. Localization heals. People focus on their inner lives. More and more people meditate. For a short period working from home becomes the norm. However, states still do not support employees in this process as trust is a factor. Thus, after the pause, back to business as usual. We slowed down in order to speed up again.

See: https://www.medscape.com/viewarticle/926806. Accessed 17 March 2020.

3. Global Heath Awakening

Large AI companies, science, start-ups, and public health expertise come to the rescue. We truly enter the digital fourth wave era – genomics plus AI help monitor and then prevent. The five ‘p’ health model – prevention, precision, participation, partnership, and personalization become the norm. There is a breakthrough after breakthrough with innovation (real-time detection, health monitoring using big data) cascading through the system. While the virus began in China, the nation leads in innovation as it is forced to adapt. Toynbee’s creative minority via open-source science and technology lead the way. Working from home booms as new relationships between employer and employee are created. Universal basic income is supported as the strength of a society is based on how we treat the weakest; not how we glorify the strongest. Young people are no longer the future, but the present. This the disruption that truly creates the fourth industrial revolution. Along with external innovation, there is inner innovation – a social revolution. Evidence-based science and technology inform public policy; not the whims of particular leaders. The insights from fighting Covid 19 are applied to climate change. There is a dramatic shift to plant-based diets. It is business transformed, social mutation,[3] not back to usual. There are, however, concerns about privacy.

The Global Awakening: https://in5d.com/the-global-awakening/

4 The Great Despair

Not an apocalypse, not a depression, no magic – just a slow and marked decline of health and wealth. Walls appear everywhere. The World Health Organization and others try to contain, but the virus repeatedly slips in and infects the bodies, minds, and hearts of all. Back to the European Middle Ages. The efforts to address fail. The least connected to globalization fare the best. The vulnerable are forgotten. Inter-generational memory of past pandemics inform.

Depending on one’s worldview the future looks very different. Certainly, the first scenario represents emotional fears. The Needed pause and Alibaba magic are based on breakthroughs in science and technology by Big pharma and Tech with varying levels of individual and social intervention. The Great Despair represents a failure to wisely act." (https://jfsdigital.org/2020/03/18/neither-a-black-swan-nor-a-zombie-apocalypse-the-futures-of-a-world-with-the-covid-19-coronavirus/?)


On the predictability of the Coronavirus outbreak

Sohail Inatullah

"Our colleague Louis Zheng from the Shanghai FuturistCircle suggested that no one had predicted COVID 19 Coronavirus. “Is it a black swan?” he asked.

Our response was that this is not a black swan, as a black swan event is defined as being unpredictable, a total surprise. The reason this coronavirus is not a black swan is that the emergence of another coronavirus was predicted by many working in the emerging infectious diseases (EIDs) field. Indeed, we argue that we need to be getting ready for the next “Corona”.

The predictability is on a number of fronts.

1. The increasing rate of emerging EIDs is well recorded in the scientific literature (Morse 1995).

2. Many agreed for some time that the most likely severe EIDs would be caused by single-stranded RNA viruses (as these have high rates of mutation) and would emerge from animals. This simply reflects the recognition that more than 70% of recent EID events have their origins in animals (they are zoonotic) with most originating principally from wildlife (Jones et al. 2008).

3. Coronaviruses were high on the list of likely candidates for causing an EID event. Severe Acute Respiratory Syndrome (SARS) emerged in 2003, Middle East Respiratory Syndrome (MERS) in 2012 – both caused by novel coronaviruses (Fan et al. 2019).

4. Bats as a likely source of viruses causing EIDs have also been well recognized in the scientific literature (Olival et al. 2017).

5. Research on both SARS and zoonotic avian influenza identified infection spillover pathways that most often included ‘wet markets’ where live animals are frequently sold and slaughtered on site. In the case of zoonotic influenza, the spread of the virus to people was from poultry at live bird markets (i.e. wet market). For SARS, the initial spillover event occurred at a wet market containing wildlife when people were exposed to civets that were shedding the SARS coronavirus (Webster 2004). Although there has been work in trying to change wet markets (FAO 2015) and in some countries stop wet markets—especially where many species, including wildlife mix—this change has been difficult due to a range of social, economic and cultural factors. We anticipate in the short run these factors will reduce in importance, but insofar as “culture eats strategy for breakfast,” they are likely to return without global institutional and cultural shifts.

All the above was known before COVID 19, so people working in the EID space were not surprised. The exact timing of emergence was not predicted, but nonetheless, the emergence of a novel coronavirus associated with wet markets containing wildlife was not unexpected at all (Fan et al. 2019).

Foresight, of course, is not about exact timing – that is market investment and stock trading. This is about creating the capacity to anticipate tomorrow’s problems and act today. Thus, the seeds of the Corona, the weak signals, have been present for a decade." (https://jfsdigital.org/2020/03/18/neither-a-black-swan-nor-a-zombie-apocalypse-the-futures-of-a-world-with-the-covid-19-coronavirus/?)