Sunday, September 05, 2021

Is a pandemic like a war?

I may update this list from time to time as I think of (or am instructed about) new aspects.

Yes

  1. You have an identifiable enemy that is killing you.
  2. You have reasonably clear and achievable objectives. To be accurate, the USA has not fought with clear and achievable objectives for several wars now, but that’s because we’ve been idiots.
  3. You need collective action to achieve those objectives.
  4. Some of your people are going to die, and a lot are going to suffer, and the means you devise for the “fight” will cause some suffering, lots of opportunity costs, and probably some deaths.
  5. Reaching your objectives requires money. The more your economy is crippled, the harder it will be to reach your goal—and you will have additional deaths because people rely on that economy. For the USA that can mean crippled transportation systems that don’t provide cities the food/fuel/medicines they need; for a poorer country that can mean that farmers starve because the army has confiscated their crops.
  6. ”The enemy gets a vote.” You have to be ready to adjust your plans.
  7. You will do unhappy and unjust things: seizing goods, locking people up ("quarantine" comes from a 40-day detention)--and in war killing people.
  8. Your means need to be commensurate with the threat. Scorched-earth may be an appropriate tactic when Germans are invading the USSR, but it wouldn’t be appropriate if Mexico were invading the USA.
  9. Some people will get rich off the new requirements, whether drug or ammo manufacturers. You may have to intervene to keep this from getting out of hand, but you need them to benefit to keep supplies coming. “Useful profiteers.”
  10. Some people will try to use emergency powers to enrich themselves or entrench themselves in control. “Evil profiteers.” The tools and restrictions intended for defeating the enemy can be turned against your own people.
  11. Internecine quarrels about means and promotions and whatnot will be ugly, cause a great deal of damage, perhaps lose you your war—and are unavoidable.
  12. You need accountability for the results. If marching men out of the trenches into no-mans-land just gets them machine-gunned, somebody needs to be told to stop that.
  13. Wars are full of lies trying to nudge the population, cover up screwups, and prevent panic.
  14. You have to make decisions without enough information.
  15. You are afraid. Too much fear is bad--you lynch Germans during WW-I or fail to press on against the Confederates at Yorktown. Too little and the Barbarossa plan catches you by surprise.

No
  1. There is nobody who can surrender. You can kill enough human enemies to make them stop whatever they were doing. You can’t kill all the viruses. Smallpox was an exception—it was easy. Ebola is hard.
  2. As a consequence of the above, either the infectious agent or the treatment will keep on killing some number of your people forever. If you can reduce the rate to something small, your emergency is over. 0 deaths is not possible with dangerous disease.
  3. Everybody dies. You can defeat one foreign enemy, but one of the domestic ones (cancer, heart disease, murder) is going to get you sooner or later. The temptation for mission creep and battling the next disease ("it's almost as dangerous!") will probably be overwhelming.
  4. In a war, if you didn’t have a dedicated enemy when you started, you do now—you can’t just say “Oopsies” and stop. If you find a pandemic to be less of a problem than you thought, you can “just stop.” The hard problem will be getting the powers-that-be to admit they were wrong.
  5. Against an epidemic, your tactics will always partake of "scorched earth," damaging your economy and future. In wars, that's only sometimes true.

Yes and No
  1. It depends on the intensity. A mild disease is more like the random Muhammadans going on solo jihads in London. You can let the existing systems (police in one case, medical in the other) take care of the problem. A more dangerous disease is comparable to them being organized and funded, as with 9/11. You need to bring new tools to bear on the problem. Ebola would be like an invasion.

Obviously the tools differ: chemicals, quarantines, research, crash programs to redo HVAC (for airborne pathogens) vs the familiar trucks, bullets, and bombs. But they’re both expensive and have huge opportunity costs.

As a thought experiment, imagine a disease spread by contact, with a week-long incubation period during the last three days of which the victim is contagious, with a 40% death rate.

The disease appears in Sao Paulo, spreads quickly, and is quickly identified.

You’re the director of Epidemic Security. Congress has just voted a (possibly merely the first) 30-day state of emergency. The country is going to be “invaded.” What do you do?

Just a few quick ideas: shut down the borders and all international travel until quarantine centers are built. Plan for 2+ week quarantines—1-week is the average incubation period, not an exact one. Unauthorized border crossing is an existential threat, and met with deadly force. Ration bleach, alcohol, peroxide, etc. Begin construction on inter-“zone” quarantine stations designed for isolation and disinfection. With luck you won’t need them, but you probably won’t have any luck.

Does that sound Chinese to you? It should also sound Italian, and French, and so on—people take deadly epidemics deadly seriously.

Once the disease appears inside the country, you have to become radical—otherwise 40% means a lot of people die. Isolate infected zones. Within the zones, nobody goes outside for a week or so. (This will kill some people—not enough food, not enough meds, uncooperative.)

The economy takes a huge hit. Even after it’s all over, lots of jobs will be gone forever, and you’ll have more poverty. But then, 40% death rate would do even worse.

Now modify the situation. (Parallel extreme cases sometimes help illustrate principles.) Suppose the death rate is 99%.

Borders close. No admittance, whether or not you’re a citizen. Civilian monitors augment the Coast Guard watching the coast. Preemptive inter-“zone” traffic stops at boundaries for 20-day quarantines. Civilian monitors watch back roads. People starve. Measures get even harsher if the disease gets a foothold in the country.

Now modify the situation to its opposite. Suppose the plague will only kill everyone over 100 with heart disease.

Would you do anything at all? Maybe invite the likely victims to live in bubbles, if that. This doesn’t qualify as a public emergency.

The typical year's annual flus don't meet the threshold for an emergency. We're fortunate that the medical system has vaccines that help, but even without them it hadn't been a disaster-level problem. That's not comforting to my friend's wife--he died from the flu a few years ago.

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