I mean, we won't, but we should

After SARS, East Asian countries were scared shitless and got their shit together for the next pandemic. Now that SARS‑CoV‑2 has hit everybody, we need to get our shit together now. Not for COVID-19, but for the next one. Like East Asia, we have to build up our public immune systems. This is how.

The First Realizations

Before getting to what exactly, we need to discuss why. There are a few important realizations about our current reality.

1. The first realization is that a pandemic is not a short-term problem. You can’t just fight the pandemic in front of you, you have to prepare for pandemics in general.
2. The second realization is that pandemics are global by definition. The word literally means global disease. Without cooperation regardless of whatever conflicts you’re having, everyone is fucked.
3. The third realization is that we have two immune systems, one personal and one public. Public health has to catch new pathogens, our personal health is too weak.
4. The final and most important realization is that pandemics are environmental problems. If we keep fucking with the environment, the environment will keep fucking with us.

I’ll go over each of these points here, but if you go no further, just know this. Another pandemic is coming, public health is our only protection, and environmental degradation is the root cause.

4. Work The Root

I’ll do this backwards because the root is the most important part. Everything else is just pruning branches. The more we encroach on the natural world, the more the natural world will encroach on us. The more we push into animal habitats, more bacteria and viruses will inhabit us. This is the iron law.

Especially with climate change, we are unlocking god knows what. As temperatures rise globally, tropical diseases like dengue will suddenly become topical everywhere else. As permafrost thaws in the Artic, frozen bacteria there will reawaken. As ecosystems collapse, who knows what will come scurrying out.

Without fundamentally addressing our relationship with the outside world we cannot fix our inside relationship with bacteria. The root cause of pandemics is not actually viruses or bacteria. Your body is covered with trillions of bacteria and viruses right now, most of them harmless or helpful. The problem is balance.

We are out of balance with the world so of course our inner world is imbalanced. This is inevitable, it is all one system. When we fuck with the world we fuck with ourselves. We have to stop.

As our population growth slows and begins to decline we have to begin degrowing our economies and prioritizing health and human outcomes over money (for the few). Capitalism is, fundamentally, a cancer on the planet, and until we cut that out the symptoms will keep getting worse. Hence what is required is not just incremental environmental change. What’s required is outright revolution.

3. The Two Immune Systems

Second, just as we are not separate from the Earth, we are not separate from each other. A virus doesn’t see humans as separate things, it just sees one biological soup. We have to start thinking that way.

Your personal immune system keeps a list of problems, identifies known pathogens, and isolates and destroys them. All public health is is these principles writ large. Public health monitors known diseases, isolates them, and hopefully eliminates pandemics before they become pandemonium. This is the infrastructure we need to build.

You can see this infrastructure working in China, for example. After SARS they got shit scared and actually built this stuff out. The most crucial thing they built up was fear. People knew to take diseases seriously (it’s not ‘just the flu’) and the CPC took any outbreak as a serious threat to its own stability.

Hence when COVID-19 hit, they reacted with overwhelming force, quarantining and entire major province and sticking to the target of elimination, not living with this shit. This is the only appropriate response. Your body does not generally ‘live with’ disease, it eliminates or dies trying. Public health has to follow the same principle.

Like a human immune system, Chinese public health relentlessly tested-and-traced every single case. Testing is actually the most important thing. PCR testing is the only significant technological advance since vaccines and it can be intelligently batched to test millions of people at once, which they did. For each new outbreak they tested the entire city, often overnight. This is the level of vigilance required. If it seems like a lot, the alternative is doing a lot more over fucking years. You need to go fast and go hard.

If your public immune system is good enough at A) reacting quickly B) finding every single case and C) isolating, you can actually eliminate disease without vaccines, as China has done.

Crucially, however, this was only possible for China because they had SARS experience. Once-bitten, twice shy. Hence similarly scarred places like Taiwan, Vietnam, Mongolia and, to a lesser extent, South Korea and Japan were able to respond quickly, albeit less decisively.

The vital lesson they all learned was that you have to build a second immune system. That means physical infrastructure, headquarters, media centers, org charts, boots on the ground. You can read the detailed South Korean playbook for more or observe Taiwan if learning from China is ideologically impossible for you. Whatever it is, building up this public immune system must be done.

Improving Public Immunity Through Poop

Given that we are, as mentioned, sailing into a century of fuckery, we may need more than the usual test/trace/isolate regime. One novel idea is that cities at least can be PCR testing everyone all the time, passively. Places with centralized sewers are able to continually test wastewater, where everyone dutifully drops a sample at least once a day. Thus if someone in Senegal releases a genome, you can immediately see if it’s circulating in your population. It won’t tell you who or exactly where, but it will tell you if.

If cities are storing samples, this also makes tracing the source of an outbreak much easier, as you can go back and test old samples.

Vaccination Factories All Over The World

As Dr. Tom Frieden and many others have proposed, mRNA factories can be cheaply setup all over the world. It’s actually a simpler technology than traditional vaccine making. The first COVID-19 mRNA vaccines were actually ready within days of China releasing the genome, the months were only required for testing. If mRNA factories are everywhere and patents are no object, then humanity can start spinning up vaccines almost as soon as a pathogen is discovered.

Right now corrupt western governments are guarding mRNA technology like nukes, but we in the global majority can and will figure this out. However, we still need to overthrow their control on institutions like the WTO in order to make this is truly viable tool.

However, I will close this section by saying that fighting pathogens, no matter how awesome we get at it, is still vastly inferior to not unleashing pathogens in the first place, ie not fucking with the environment. We can try to make a bonsai tree out of pandemics, but the key thing is that the overall tree must remain small.

2. Global Cooperation

While Napolean was fighting the English, he cooperated happily with the Englishman Edward Jenner, saying “we can refuse nothing to this man.” Jenner could freely cross enemy lines because he was fighting smallpox, their shared enemy. As Jenner said “the sciences are never at war.”

With COVID-19, however, western countries made a pandemic a front in a fucking Cold War, attacking China. This is historically unprecedented. Even during the last Cold War, the US and USSR cooperated on public health.

Today Western countries like the US and EU have frankly become enemies of all humanity. They have not just attacked China, they have blocked Cuba from getting syringes, Venezuela from getting vaccines, and continued ruinous sanctions on places like Iran during a seige. When South Africa sequenced the latest Omicron straing, they punitively blocked travel from much of Africa, despite the strain already circulating in Europe. This is all simply unconscionable, and self-defeating. These ignorant, racist fuckers are defeating us all.

During a pandemic countries have to put all their petty shit down and unite against an enemy. Pathogens know no borders between human bodies, and they certainly don’t know the invisible borders we draw on maps. In my opinion this is impossible without overthrowing western hegemony over the ‘international community’, which is why I say again that global revolution is necessary not just for human freedom and equality but for human survival.

1. Pandemics Are Here To Stay

As long as humans connect we will get pandemics. We have always had pandemics and we always will. As long as humans connect, microbes will hop across our mouths, noses, and dicks to form one continuous biome across the Earth. Modern society has accellerated the speed at which pandemics spread, but they were always there.

Hence the most vital and yet the most often neglected lesson of pandemics is to prepare for the next one. The 1918 pandemic was a big one, and yet it is shocking to me how little I ever learned about it. I actually learned zero. If COVID-19 is (not) remembered the same way we will certainly be seeing BEELZEBUB-19 next century. The one hope is how much East Asian countries learned from SARS, and our increasingly rapid ability to test and produce vaccines.

And yet none of that technology is substitute for the wisdom to realize the root of the problem. While pandemics are here to stay, they only get this fucked when humans are so out of balance with each other than the Earth. It is folly to overpower pandemics through technological might. We’ll just get mighter pandemics. We have to humble ourselves before nature. That is true adaptation. That is right.

The Future

My predictions for the future are actually dire and I don’t think the corrupt imperialist, capitalist systems that made this pandemic so shit are just going to go away. Western empire is too deformed to reform, it’s just going to have to come crashing down. That of course will leave a bigger mess before it ever gets cleaned up.

My point here is really a hypothetical one. A future pandemic response should involve long-term, global, public health thinking. It should involve radical changes to global power structures and our very relation to the Earth. Will these things happen? I dunno. Certainly not now. But they are nonetheless necessary, and God will certainly keep knocking down our tower of Babel unless we disce aut discede. Until we learn or depart.

I’ve written more about the intersection of this virus with everything here.