By Sohail Inayatullah and Peter Black
Our colleague Louis Zheng from the Shanghai FuturistCircle suggested that no one had predicted COVID-19 Coronavirus. “Is it a black swan?” he asked.[1]
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 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 RNA viruses as these have high rates of mutation (Cleaveland et al. 2001) 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) (Woolhouse and Gowtage-Sequeria 2005) 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 (Ge et al. 2013, 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 this COVID-19 pandemic, the weak signals, have been present for a decade or more.
Culture Eats Strategy For Breakfast
Why then with this information are we now in the middle of a pandemic? Colleagues in the People’s Republic of China (PRC) suggest that: Firstly, “it is related deeply to the Chinese eating culture – preference for fresh meat from animals butchered at the counter”. Secondly, the memories of food crises in China remain. Third, there continues to be a level of mistrust of the government. For example, “residents have little knowledge of the frozen meat-producing process due to the lack of information transparency, thus, some ignore the regulations of the live animal ban in the wet markets.” They are bounty hunters, focused on wealth creation, irrespective of the costs to the overall society.
Furthermore, many from rural areas live in the ancient episteme where the “liveness” of the animal leads to greater health as one is “eating” life. Thus, the initial lack of response speed can be explained not just by a culture where informing supervisors equates with a fear of losing one’s job – but because parts of China live in different times. An ancient worldview, a communist worldview, and now a globalist worldview. Certainly, since the initial issue of transparency emerged, China’s response has been robust and dynamic. The speed of virus spread has been dramatically reduced, giving the rest of the world a chance to mitigate.
Social problems emerge, or are difficult to address, where there are varying perspectives – each often in tension with others. Interests and strategies are at locked horns or drawing the carriage in different directions.
This is illustrated in the Causal Layered Analysis (Inayatullah and Milojević, 2015) below. Six meta-perspectives are critical – the views from those who sell in wet markets; the views of those in the political bureaucracy (this helps explain the rise of COVID-19 in China early on in the outbreak and Iran, for example); the current strategy of slowing down the virus – the Medieval; the Pharma perspective; the Market; and of course, the Citizen.
| Wet market | Political bureaucracy | Public health | Pharma | Economic | Citizen | |
| Litany | Continued wet markets | Information about disease not shared | Slow down the virus so systems can survive | Enlist medical and health systems to create the cure | Economic indicators – recession on the way | Fear and panic
|
| System | Jobs in tension with the need to eliminate them.
Outside of the law. |
Job – fear of reprisal from those above | Quarantine,
Social distancing, Surveillance, Lockdown, Flatten the curve. Use apps and Artificial Intelligence (AI) |
Find the vaccine.
Vaccinate all. Using new technologies to speed up solutions |
Profits and interconnected systems cause downward pressure.
Uncertainty driving market volatility. |
Citizens looking for direction. Leaders uncertain of how to balance the economy and public health.
|
| Worldview | Economic – wealth accumulation | Political – authoritarian | Medieval-Safety | Pharmaceutical – plus AI plus to some extent public health | Capitalist – markets | Citizen prefer flatter systems, but search for expertise
|
| Myth/metaphor | “Bounty hunters”
“Show me the money” |
“The big man” | “Breaking the chain of infection”
“Slow down the fire” |
“Silver bullet” | “Where to hide” – “opportunities everywhere” | “Whom do I trust”
|
Thus part of the challenge of a global response is that there are multiple worldviews operating, all with different interests.
While CLA helps us to understand the varying perspectives, scenarios help us address alternative trajectories.
What Then Are The Scenarios?
Based on the hundreds of articles, we see at least four possible futures. [2]
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.
Image 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, those with underlying medical conditions 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.
Flattening the curve. https://www.medscape.com/viewarticle/926806. Accessed 17 March 2020.
3. Global Health 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 artificial intelligence (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 is 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.
Illustration: Charmaine Sevil
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.
https://www.usu.edu/markdamen/1320hist&civ/chapters/06plague.htm
Depending on one’s worldview the future looks very different. Certainly, the first scenario represents emotional fears. The Needed Pause and Global Health Awakening 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.
Conclusion and Next Steps
To prevent the next outbreak, first, a global ban on wet markets and trade in wildlife with real help to transition sellers so they are not impoverished. This is a huge undertaking as both the number of people involved in the wildlife trade and its global economic value are enormous. China’s wildlife industry alone is valued at $74 billion USD. However, the cost to China of this outbreak will be many times larger than this, even if only taking account of losses associated with tourism and consumer spending (South China Morning Post 22 and 24 February 2020 as cited in Machalaba and Karesh 2020).
However, there are potential barriers: Even though banning wildlife trade may make economic sense, there could be a cultural backlash – ‘Why should I have to live without access to the foods that make me strong. This is the West dictating too much about my lifestyle!’
Irrespective of the success of banning the wet markets and trade in wildlife, the economic costs of this COVID-19 pandemic will be debated and analyzed in great detail. The argument will most likely be made to invest in the same strategies that were suggested post-SARS, and the influenza H1N1 pandemic of 2009 — strategies that were only partially funded and implemented. That is, there will be a support to continue with the status quo and steady the ship by ensuring countries can all meet the International Health Regulations and ‘manage’ the next epidemic or pandemic challenge.
Second, there should be increased interest in detecting disease, even earlier, especially in areas of increased risk of emergence and disease spillover. This will likely support full investment in new technologies such Next Generation Sequencing (NGS), Big Data, AI and AI combined apps that can detect diseases.
https://bizedge.co.nz/story/the-tech-on-the-frontlines-of-the-fight-against-covid-19. Accessed 17 March 2020.
Third —and critically—will be the increased investment in real prevention strategies that acknowledge that the majority of zoonotic pathogens have emerged as a result of changes to food production, agriculture, land use and contact with wildlife (Allen et al. 2017). This could result for example, in the creation of buffer zones between wildlife and human settlements, or cost-benefit studies of new agricultural projects and land-use change that take into account increased EID risk, such as COVID 19. Even more fundamentally, real prevention strategies will mean re-thinking the current “more, more, more” development model. Taking an Eco-health view, we argue that Nature strikes back. Always.
https://loonylabs.org/2015/06/27/buffer-zones-humans/ Accessed 11 March 2020.
In conclusion: this crisis is a health crisis but, of course, it is much more. It is about leadership and governance, about what type of world we wish to live in. It is a test of the creation of a planetary civilization, working together to solve problems.
If we do not succeed, the next ‘Corona’ is just around the corner.
About the Authors
Sohail Inayatullah, UNESCO Chair in Futures Studies, USIM, Professor, Tamkang University, Taiwan and Associate, Melbourne Business School, the University of Melbourne. sinayatullah@gmail.com. www.metafuture.org
Dr. Peter Black, One Health Foresight Consultant and Veterinary Epidemiologist peter@essentialforesight.com www.essentialforesight.com
Special thanks to Russell Clemens for copy editing the manuscript
References
Allen, T., Murray, K.A., Zambrana-Torrelio, C. et al. Global hotspots and correlates of emerging zoonotic diseases. Nat Commun 8, 1124 (2017). https://doi.org/10.1038/s41467-017-00923-8
Inayatullah, Sohail and Ivana Milojević. 2015. CLA 2.0: Transformative Research in Theory and Practice. Tamsui: Tamkang University Press
Centre for Disease Control and Prevention. Zombie Preparedness. https://www.cdc.gov/cpr/zombie/index.htm Accessed 11 March 2020.
Cleaveland S, Laurenson MK, Taylor LH. Diseases of humans and their domestic mammals: pathogen characteristics, host range and the risk of emergence. Philos Trans R Soc Lond B Biol Sci. 2001;356(1411):991‐999. doi:10.1098/rstb.2001.0889
Fan, Y.; Zhao, K.; Shi, Z.-L.; Zhou, P. Bat Coronaviruses in China. Viruses 2019, 11, 210
Ge, X., Li, J., Yang, X. et al. Isolation and characterization of a bat SARS-like coronavirus that uses the ACE2 receptor. Nature 503, 535–538 (2013). https://doi.org/10.1038/nature12711
Jones, K., Patel, N., Levy, M. et al. Global trends in emerging infectious diseases. Nature 451, 990–993 (2008). https://doi.org/10.1038/nature06536
Inayatullah, Sohail and Ivana Milojević. 2015. CLA 2.0: Transformative Research in Theory and Practice. Tamsui: Tamkang University Press
Machalaba, C and Karesh B Fight Pandemics Like Wildfires With Prevention and a Plan to Share the Costs, Foreign Affairs (6 March 2020)
Morse SS. Factors in the Emergence of Infectious Diseases. Emerging Infectious Diseases. 1995;1(1):7-15. doi:10.3201/eid0101.950102
Olival, K., Hosseini, P., Zambrana-Torrelio, C. et al. Host and viral traits predict zoonotic spillover from mammals. Nature 546 646–650 (2017). https://doi.org/10.1038/nature22975
South China Morning Post 22 Feb 2020 https://tinyurl.com/vexekzd
South China Morning Post 24 Feb 2020 https://tinyurl.com/y8xxxu9h
Webster, R. Wet markets—a continuing source of severe acute respiratory syndrome and influenza?:The Lancet, 363, Issue 9404, 17 January 2004, 234-236
Woolhouse ME, Gowtage-Sequeria S. Host range and emerging and reemerging pathogens. Emerging Infectious Diseases 2005;11(12):1842‐1847. doi:10.3201/eid1112.050997
United Nations Food and Agriculture Oganisation (FAO 2015) Biosecurity guide for live poultry markets. http://www.fao.org/3/a-i5029e.pdf. Accessed 13 March 2020
- Personal email. February 10, 2020 ↑
- These are best used as points of departure, to capture uncertainty and create alternative futures ↑
- To use the words of Satya Tanner. Facebook post. March 6, 2020. ↑
