I’m not terribly willing to treat them as an “existential” risk, since countless pandemics already happened and for natural reasons they never actually kill the entire population.
And the way how awesomely we’ve dealt with SARS is a good data point showing that pandemics might actually be under control now. At least we should have far more confidence in our ability to deal with pandemics is far better than our ability to deal with just about any other existential threat.
And one nice side effect of just plain old medicine is reduction of this existential risk, even without any efforts specifically towards handling existential risk. Every antibiotic, every antiviral, every new way of keeping patients alive longer, every diagnostic improvement, every improvement in hygiene in poor countries etc. - they all make pandemics less likely and more manageable.
I’m not terribly willing to treat them as an “existential” risk, since countless pandemics already happened and for natural reasons they never actually kill the entire population.
Most major pandemics have occurred before modern transport was common. The presence of easy air travel makes a serious pandemic more problematic. And in fact if one looks at emergent diseases in the last sixty years, such as HIV, one sees that they are effectively taking advantage of the ease of transport in the modern world.
HIV emerged before modern medicine developed. It was discovered in 1981 - almost prehistory by medical standards, but it was actually transfered to humans somewhere in late 19th century. It wrecks the most havoc in places which are extremely far from modern medicine as well, in developed countries HIV is a fairly minor problem.
SARS is a much better example of a new disease and how modern medicine can deal with it.
Even in Africa, HIV has taken advantage of modern transport. Migrant workers are a major cause of HIV spread in sub-Saharan Africa. This has advanced to the point where new road building projects think about what they will do to disease transmission. These laborers and the like aren’t just walking- the possibility of such migrant labor is connected to the fact that even in the developing world, buses exist.
Oh, I somehow skipped seeing that in the OP. I don’t think our ability to deal with mundane bugs has much transferability to our ability to deal with super bugs.
There’s really no such thing as a “super bug”. All organisms follow the same constraints of biology and epidemiology. If there was even some magical “super bug” it would infect everything of any remotely compatible species, not be constrained to one species, and small subset of cells in it.
We might not have any drugs ready for a particular infection, but we didn’t have any for SARS, it was extremely infectious, and extremely deadly, and it worked perfectly fine in the end. We have tools like quarantine, detection etc. which work against any disease known or unknown.
I cannot really imagine how it could be going better than that.
This doesn’t fully apply to hypothetical manmade pandemics, but currently we don’t really know how to make such thing (the best we can do it modify existing disease to be a bit more nasty, creating diseases de novo is far beyond our capabilities), nobody has any particular desire to do so, and any broad spectrum countermeasures we develop against natural diseases will likely at least partly apply against manmade diseases in any case.
Except the fact they wouldn’t be particularly lethal.
If 100% of humans had HIV, it would increase probably make most countries disregard patent laws on a few drugs, and human life spans would get shorter by like 5-10 years on average.
If 100% of humans had HIV, it would increase probably make most countries disregard patent laws on a few drugs, and human life spans would get shorter by like 5-10 years on average.
I bet the statistics are assuming nothing else changes. It’s plausible to me that a society where people are generally sicker and shorter-lived will be poorer, and there will be a lot of additional deaths due to people being able to produce less stuff. It’s also conceivable that the lower population will be an advantage because of less competition for natural resources and already-existing durable goods.
Probably both tendencies will be in play. This makes prediction difficult.
The thing is countries would not really be poorer. Properly treated HIV isn’t much worse than smoking (I mean the part before lung cancer) or diabetes for most of people’s lives. Countries differ a lot on these already, without any apparent drastic differences in economic outcomes.
By the time people are already very old they might live a few years less, but they’re not really terribly productive at that point anyway.
That’s already old data by standards of modern progress of medicine, and groups that tend to get HIV are highly non-random and are typically engaged in other risky activities like unprotected promiscuous sex and intravenous drug use, and are poorer and blacker than average, so their baseline life expectancy is already much lower than population average.
There’s really no such thing as a “super bug”. All organisms follow the same constraints of biology and epidemiology. If there was even some magical “super bug” it would infect everything of any remotely compatible species, not be constrained to one species, and small subset of cells in it.
The term does not imply magic, it merely implies nasty. Smallpox and Spanish flu were both superbugs in every meaningful sense, but they worked on DNA just like everything else. The question is not whether someone builds a flesh-eating nanite our immune system can’t handle or whatever, it’s just about whether an infectious disease comes along that’s worse than our medical system can cope with. That is a much lower bar.
Smallpox wasn’t that bad if you look at statistics, and spanish flu happened at a time when humans have been murdering each other at unprecedented rate and normal society was either suspended or collapsed altogether everywhere.
Usually the chance of getting infected is inversely correlated with severity of symptoms (by laws of epidemiology), and nastiness is inversely correlated with broad range (by laws of biology), so you have diseases that are really extreme by any one criterion, but they tend to be really weak by some other criterion.
And in any case we’re getting amazingly better at this.
The disease killed an estimated 400,000 Europeans per year during the closing years of the 18th century (including five reigning monarchs),[7] and was responsible for a third of all blindness.[3][8] Of all those infected, 20–60%—and over 80% of infected children—died from the disease.[9] Smallpox was responsible for an estimated 300–500 million deaths during the 20th century.[10][11][12] As recently as 1967, the World Health Organization (WHO) estimated that 15 million people contracted the disease and that two million died in that year.[13]
I agree that there were aggravating factors, particularly in the Spanish flu case, and that tradeoffs between impact and spread generally form a brake. But nasty diseases do exist, and our medical science is sufficiently imperfect that the possibility of one slipping through even in the modern world is not to be ignored. Fortunately, it’s a field we’re already pouring some pretty stupendous sums of money into, so it’s not a risk we’re likely to be totally blindsided by, but it’s one to keep in mind.
The disease killed an estimated 400,000 Europeans per year during the closing years of the 18th century
So? 400,000 people a year is what % of total mortality?
As recently as 1967, the World Health Organization (WHO) estimated that 15 million people contracted the disease and that two million died in that year.
In an important way diseases don’t kill people, poverty, hunger, and lack of sanitation kills people. The deaths were almost all happening in the poorest, and the most abused parts of the world—India and Africa.
So? 400,000 people a year is what % of total mortality?
World population in 1800 was about a billion, and we’ll ballpark 1/5th of the population being in Europe and 1/40th of them dying per year(which is probably better life expectancy than the world had, but about right for Europe). That means about 5 million deaths per year, so 400k would be 8%. And it’s not like smallpox was the only plague around, either.
In an important way diseases don’t kill people, poverty, hunger, and lack of sanitation kills people. The deaths were almost all happening in the poorest, and the most abused parts of the world—India and Africa.
In an even more important way, diseases kill people. Yes, if smallpox came back today(or a non-vaccinatible equivalent) it’d kill a lot fewer people than it used to because of better quarantine, sanitation, and all that fun stuff. Same way AIDS is a minor problem here and a world-ender in sub-Saharan Africa. But it’s not like we lack for infectious disease in the developed world.
pandemics, man-made or natural.
Yeah, I’ve mentioned pandemics already.
I’m not terribly willing to treat them as an “existential” risk, since countless pandemics already happened and for natural reasons they never actually kill the entire population.
And the way how awesomely we’ve dealt with SARS is a good data point showing that pandemics might actually be under control now. At least we should have far more confidence in our ability to deal with pandemics is far better than our ability to deal with just about any other existential threat.
And one nice side effect of just plain old medicine is reduction of this existential risk, even without any efforts specifically towards handling existential risk. Every antibiotic, every antiviral, every new way of keeping patients alive longer, every diagnostic improvement, every improvement in hygiene in poor countries etc. - they all make pandemics less likely and more manageable.
Most major pandemics have occurred before modern transport was common. The presence of easy air travel makes a serious pandemic more problematic. And in fact if one looks at emergent diseases in the last sixty years, such as HIV, one sees that they are effectively taking advantage of the ease of transport in the modern world.
HIV emerged before modern medicine developed. It was discovered in 1981 - almost prehistory by medical standards, but it was actually transfered to humans somewhere in late 19th century. It wrecks the most havoc in places which are extremely far from modern medicine as well, in developed countries HIV is a fairly minor problem.
SARS is a much better example of a new disease and how modern medicine can deal with it.
Even in Africa, HIV has taken advantage of modern transport. Migrant workers are a major cause of HIV spread in sub-Saharan Africa. This has advanced to the point where new road building projects think about what they will do to disease transmission. These laborers and the like aren’t just walking- the possibility of such migrant labor is connected to the fact that even in the developing world, buses exist.
Oh, I somehow skipped seeing that in the OP. I don’t think our ability to deal with mundane bugs has much transferability to our ability to deal with super bugs.
There’s really no such thing as a “super bug”. All organisms follow the same constraints of biology and epidemiology. If there was even some magical “super bug” it would infect everything of any remotely compatible species, not be constrained to one species, and small subset of cells in it.
We might not have any drugs ready for a particular infection, but we didn’t have any for SARS, it was extremely infectious, and extremely deadly, and it worked perfectly fine in the end. We have tools like quarantine, detection etc. which work against any disease known or unknown.
Medicine made a massive progress since then—mass sequencing of infectious genomes for quick reaction time is now far more practical, and we might soon even get broad spectrum antivirals.
And we’ve eradicated two diseases already (smallpox, rinderpest) with two more being very close to eradication (polio, dracunculiasis), and it’s not like anybody has any intentions of stopping the total at 4. We’ll keep eradicating diseases, even if it takes a decade or two for each such attempt. Every time we manage to do that, there’s one less source of potential pandemic.
I cannot really imagine how it could be going better than that.
This doesn’t fully apply to hypothetical manmade pandemics, but currently we don’t really know how to make such thing (the best we can do it modify existing disease to be a bit more nasty, creating diseases de novo is far beyond our capabilities), nobody has any particular desire to do so, and any broad spectrum countermeasures we develop against natural diseases will likely at least partly apply against manmade diseases in any case.
AFAIK nothing precludes extremely lethal bugs with long incubation periods. As for “nobody has any particular desire to”, I hope you are right.
Except the fact they wouldn’t be particularly lethal.
If 100% of humans had HIV, it would increase probably make most countries disregard patent laws on a few drugs, and human life spans would get shorter by like 5-10 years on average.
This should keep things in perspective.
My Google-fu seems to indicate a drop of about 20 years.
I bet the statistics are assuming nothing else changes. It’s plausible to me that a society where people are generally sicker and shorter-lived will be poorer, and there will be a lot of additional deaths due to people being able to produce less stuff. It’s also conceivable that the lower population will be an advantage because of less competition for natural resources and already-existing durable goods.
Probably both tendencies will be in play. This makes prediction difficult.
The thing is countries would not really be poorer. Properly treated HIV isn’t much worse than smoking (I mean the part before lung cancer) or diabetes for most of people’s lives. Countries differ a lot on these already, without any apparent drastic differences in economic outcomes.
By the time people are already very old they might live a few years less, but they’re not really terribly productive at that point anyway.
That’s already old data by standards of modern progress of medicine, and groups that tend to get HIV are highly non-random and are typically engaged in other risky activities like unprotected promiscuous sex and intravenous drug use, and are poorer and blacker than average, so their baseline life expectancy is already much lower than population average.
And remember, that’s ~20 years with ~40% infection rates, not 100%.
The term does not imply magic, it merely implies nasty. Smallpox and Spanish flu were both superbugs in every meaningful sense, but they worked on DNA just like everything else. The question is not whether someone builds a flesh-eating nanite our immune system can’t handle or whatever, it’s just about whether an infectious disease comes along that’s worse than our medical system can cope with. That is a much lower bar.
Smallpox wasn’t that bad if you look at statistics, and spanish flu happened at a time when humans have been murdering each other at unprecedented rate and normal society was either suspended or collapsed altogether everywhere.
Usually the chance of getting infected is inversely correlated with severity of symptoms (by laws of epidemiology), and nastiness is inversely correlated with broad range (by laws of biology), so you have diseases that are really extreme by any one criterion, but they tend to be really weak by some other criterion.
And in any case we’re getting amazingly better at this.
Not that bad?
I agree that there were aggravating factors, particularly in the Spanish flu case, and that tradeoffs between impact and spread generally form a brake. But nasty diseases do exist, and our medical science is sufficiently imperfect that the possibility of one slipping through even in the modern world is not to be ignored. Fortunately, it’s a field we’re already pouring some pretty stupendous sums of money into, so it’s not a risk we’re likely to be totally blindsided by, but it’s one to keep in mind.
So? 400,000 people a year is what % of total mortality?
In an important way diseases don’t kill people, poverty, hunger, and lack of sanitation kills people. The deaths were almost all happening in the poorest, and the most abused parts of the world—India and Africa.
World population in 1800 was about a billion, and we’ll ballpark 1/5th of the population being in Europe and 1/40th of them dying per year(which is probably better life expectancy than the world had, but about right for Europe). That means about 5 million deaths per year, so 400k would be 8%. And it’s not like smallpox was the only plague around, either.
In an even more important way, diseases kill people. Yes, if smallpox came back today(or a non-vaccinatible equivalent) it’d kill a lot fewer people than it used to because of better quarantine, sanitation, and all that fun stuff. Same way AIDS is a minor problem here and a world-ender in sub-Saharan Africa. But it’s not like we lack for infectious disease in the developed world.