Future pandemics: A growing existential risk
The COVID-19 pandemic may only be a taste of the natural and man-made biological dangers that lie ahead.
By Nicklas Larsen, Søren Bach Jensen, Casper Skovgaard Petersen & Marius Merz
We live in a risk society, as the German sociologist Ulrich Beck put it in his seminal book of the same name. Although the book was first published 1986, the key ideas Beck put forth still apply to our present day. Essentially, Beck posits that society has evolved from the first modernity, where the classic industrial society was able to calculate and predict the risks it was facing, to the second modernity of our contemporary age. The extremely high level of uncertainty that characterises this second modernity makes it impossible to calculate and predict risks in the same way as before. In parallel with the advent of the risk society, the global risk landscape has also become more complex and interconnected.
We have entered the era of global risks that stem from both man-made and natural sources, or a combination of both: climate change, a malevolent super AI, nuclear bombs, bioterrorism, cyber-attacks and, of course, pandemics. To further add to this complexity, there are distinctions to make in this global risk landscape. A global catastrophic risk is a hypothetical future event that could harm human well-being on a global scale, even endangering or destroying modern civilisation, whereas an event that possibly could lead to human extinction is an existential risk, as the Swedish author and philosopher Nick Bostrom defines it: ‘One where an adverse outcome would either annihilate Earth-originating intelligent life or permanently and drastically curtail its potential’.
While some of these existential risks stem from nature and are thus out of our control — asteroid impacts or super volcanoes for example — other threats facing us are man-made. Throughout history, human ingenuity has produced technologies with double-edged capabilities. Perhaps the most dramatic example came with the capability to harness the atom, with nuclear power and nuclear weapons being the by-products. This marked the dawn of a new epoch in which humankind achieved the ability to destroy itself, with a few very close calls happening especially during the Cold War. Since then, nuclear weapons have now been joined by other emerging technological risks such as nanotechnology and AI.
THE EXPANDED RISK LANDSCAPE OF PANDEMICS
Although it has been a novel experience for most people living through it, the COVID-19 pandemic was not an unanticipated event. In fact, a respiratory virus-enabled pandemic like COVID-19 was deemed likely or even expected by virologists. The interconnectedness of modern-day civilisation has made it much easier for a pandemic to spread globally in days or weeks rather than months, and the frequency of outbreaks is accelerated by ecosystem collapse, demographic developments and global warming. In any given month, The World Health Organization now traces roughly 7.000 signals of potential outbreaks, conducts 300 follow-ups, and leads 30 investigations. In the month of June 2018, for the first time ever, the WHO tracked outbreaks of six of the eight of the ’priority communicable diseases’, like Zika and MERS happening at the same time. WHO’s list of potential outbreaks also includes ‘Disease X’, representing the fact that a future epidemic or pandemic could also be caused by a pathogen unknown to us at the current time. Below, we take a closer look at some of the global trends that will accelerate the emergence and spread of disease in the future.
The rise of megacities
The transition from rural to urban life is a defining characteristic of our age. By 2050, two-thirds of the world’s 9,8 billion people will live in urban areas, up from around half of the world population living in cities today. This movement of people from the countryside to cities is driven by the promise of increased economic opportunity, access to healthcare, connections, education, and increased mobility. During the next decade, the number of megacities (defined as 10 million inhabitants or more) will increase to 39 by adding Chicago, Bogota, Luanda, Chennai, Baghdad, and Dar es Salaam to the list. With more than 80% being in low- or middle-income countries, megacities with large parts of the populations living in slums heightens the risk of disease spreading effortlessly. Novel outbreaks will have fertile ground for spreading exponentially, as seen in metropoles and travel hubs of today like New York City. The megacities of the future will be densely populated hubs for transnational commerce, mobility, and hyper-connected which all amplify pandemic risk. With the growing risk of pandemics occurring in the future, the need to bolster the pandemic resilience of cities will only get more pressing. Researchers at the Senseable City Lab at MIT offer a glimpse into some of the features of the pandemic-proof city of the future. As part of their project named ‘Underworlds’, they placed sensors in sewers to detect concentrations of illegal drugs and harmful bacteria in specific areas. The researchers propose to develop a new kind of human health census by sampling the ‘urban gut’ and thus providing early signals of things like contagious disease with geographical precision. A city built with lessons from pandemics might be filled with systems such as these to help map the spread of disease. While technology can get us some of the way, it can’t solve some of the more structural issues that lie at the heart of why and how outbreaks of disease become epidemics or pandemics. Outbreaks of disease tend to hit underprivileged or marginalised population groups the hardest, and to effectively curb the spread of disease in the future, we not only need to expand our urban and technological resilience, but arguably (and chiefly) our social and community resilience as well.
Global warming and increased human-wildlife interfacing
Pandemics and global warming remind us that nature is powerful, and that despite all our modern gadgets, we are still subject to its temperaments. Our current situation is a terrifying harbinger of the pandemics that can be brought about in the future if global warming continues to further destabilise the natural world. Already today, global warming is exposing new threats. The warming planet is melting permafrost that has been frozen for decades or longer, releasing ancient viruses and bacteria that have lain dormant. Out of the meltwater, smallpox or the Spanish flu could be given a second chance, or something completely different we do not want to discover could be ‘released’ into the world. Rising global temperatures are also expanding the geographical reach of diseases like zika, dengue fever, and malaria, as these infectious diseases and their vectors, like mosquitos, thrive better in a warmer and a more humid climate. Additionally, global warming is also changing the water cycle, leading to heavier rainfalls and higher risks of floods, and consequently spreading water-borne diseases like cholera. This is especially problematic in the world’s poorest regions which are unable to invest heavily in climate mitigation infrastructure.
COVID-19 breached natural boundaries at the interface between human activity and wild ecosystems. A major factor driving such spillover events is the loss of natural ‘buffers’ between humans and wild ecosystems, exemplified through deforestation, bushmeat hunting, and the traditional Asian open wet markets. Additionally, the world’s growing demand for domesticated meat is greatly increasing the number of pigs and chickens on the planet, increasing the chances of a pig or avian influenza to make the jump from animals to humans.
Democratisation and proliferation of biotechnology
In the past two centuries, we went from discovering the world of microbes invisible to the human eye to growing them in petri dishes, sequencing their genomes and now, altering their DNA. Just in the past 10 years, we have seen major breakthroughs in our biotechnological capabilities, such as the use of gene drives, the genetic cut-and-paste tool CRISPR-Cas9, and the world’s first genetically modified babies. A gene drive is a genetic mechanism by which a desired genetic sequence can be spread through a population faster than traditional inheritance.
This strategy can be so effective that traits can spread even if they result in a disadvantageous trait, such as sterility. Thus, gene drives present potential new solutions for a variety of issues facing humanity, including eradicating, or altering disease carriers such as mosquitoes and controlling invasive species of plants, insects, or toads. What is worrisome, however, is that these biotechnological breakthroughs are not only in the hands of state actors and institutions. The rapid democratisation of biotech has made these powerful tools increasingly available to groups from the undergraduate biologist to the DIY biohacking communities.
When the first human genome was sequenced in 2001, it took almost 15 years and the cost was around $2,6 billion. Today, a genome can be sequenced in an hour for a price of less than $1.000. While our growing biotechnological knowledge has benefits, it is a double-edged sword and can be misused — intentionally or unintentionally — in ways that can cause great harm. As the number of people with access to the technology grows, so does the risk for the technologies to be misapplied with deadly and global impact.
Error or terror: bad bugs or bad guys?
A biotechnological catastrophe may be caused by an engineered organism being accidentally released from controlled research environments, by the planned release of such an organism which then turns out to have unforeseen and catastrophic interactions with ecosystems, or by intentional usage of biological agents in biological warfare or bioterrorism attacks. The existential risks posed by most scientific and medical research is negligible. However, there is ongoing research into live agents of smallpox, SARS, H5N1, and avian flu, which, if escaped mistakenly, could wreak havoc. It is likely possible to engineer pathogens that are even more dangerous than the natural strains by increasing their incubation time, transmissibility, lethality, or resistance to vaccination and treatment. Research by well-intentioned actors into potential pathogens of pandemic, both natural — and down the road synthetic — is a path society can pursue to try to stay one step ahead of bad actors by exploring the space of possibilities and prepare adequately. Engineering pathogens to study them of course comes with its own set of dangers, but the benefits to resiliency might outweigh the risks and thus presents a fine line to be walked by the scientific community and its regulators. The technological means to genetically modify pathogenic characteristics are likely to become more widely available in the future. The main candidate for biological existential risk in the coming decades thus stems from our own technology and particularly the risk of misuse by groups or even individuals. Capabilities that were once only in the hands of governments and universities are increasingly moving into the living rooms and garages of individuals. Nick Bostrom from The Oxford Future of Humanity Institute estimates from a survey among researchers a 5% probability of a pandemic of catastrophic proportions (1 billion deaths) from natural sources by 2100 and estimate a 10% probability from an engineered pandemic.
RISK AS A PERMANENT FEATURE OF FUTURE SOCIETY
The human mind is not naturally well-wired to intuitively deal with very small probability events like winning the lottery, asteroid strikes, or pandemics. It is equally bad at dealing with multigenerational, slow moving events like climate change. The unintuitive understanding of risk is even further exacerbated by numerous cognitive biases which influence our judgments of the importance of existential risks. Be it nuclear annihilation, a hostile rogue AI, global warming, or pandemics, natural or bio-engineered, we need to care and prepare for these low-probability high-impact events. Policy implications include the formation of global biotech related governance, legislation, and enforcement, or even a global body like the IPCC or the United Nations Framework Convention on Climate Change.
On the national level, we need to be developing oversight of the use and misuse of bio-technology, research, and eventual deployment of early warning systems. On the personal level, we need to work towards recognition of the unintuitive risks, raising awareness, and proactively building societal resilience. Existential risks are, by nature, transnational and intergenerational. Acting on these risks is valuing and caring appropriately for the unborn generations. Mitigation requires global cooperation, creative solutions, and collective action. Awareness and attention is the first step to muster the political willpower and international capacity required to deal with risks on the existential scale. Human advancements create a completely new and uncertain risk landscape. As a side effect of modernity, we ourselves have created risks that challenge our very existence. However, once we understand that we all depend on each other, we can use this interdependence as a unique opportunity.
When we realise that we all share risks, we should instinctively come to the conclusion that we all share the responsibility. This realisation of shared responsibility should then be translated into shared aspirations for improvement through building strong institutions powerful enough to initiate fundamental change — change that could not have been initiated by just the few. We need to respond to globalised risks with globalised security that lays the groundwork for international efforts to minimise risks while maximising resilience. Global insecurity gives us an opportunity that has never been there before: It makes us realise that solidarity and cooperation among the collective is the only way to secure the individual in a time without global leadership.
Sources:
Anders Sandberg, Nick Bostrom: “Global Catastrophic Risks Survey”, Future of Humanity Institute Oxford University, bit.ly/3e07PjF.
Ripple et. al: “World Scientists’ Warning to Humanity: A Second Notice”, BioScience, bit.ly/2Zmt2QS
Lin et al. , ” Extensive diversity of coronaviruses in bats from China”, Virology (2017), bit.ly/2ZreBep
WHO: ” Prioritizing diseases for research and development in emergency contexts”, WHO, bit.ly/2yiNuqH
United Nations: “68% of the world population projected to live in urban areas by 2050”, UN: Department of Economic and Social Affairs, bit.ly/2XeiCjp
Ashley Jowell, Bright Zhou, Michele Barry: ” The impact of megacities on health: preparing for a resilient future”, The Lancet, bit.ly/2ZkuqmV
MIT Senseable City Lab: ”A vast reservoir of information on human health and behavior lives in our sewage”, MIT, underworlds.mit.edu/
Kris A. Wetterstrand, M.S.: ” The Cost of Sequencing a Human Genome”, NIH: National Human Genome Research Institute, bit.ly/3e3ulrX.
Interview with Martin Rees, co-founder of the Cambridge Study for the Centre of Existential Risks.
