Before the discovery of Australia, people in the Old World were convinced that all swans were white, an unassailable belief as it seemed completely confirmed by empirical evidence. The sighting of the first black swan might have been an interesting surprise for a few ornithologists (and others extremely concerned with the coloring of birds), but that is not where the significance of the story lies. It illustrates a severe limitation to our learning from observations or experience and the fragility of our knowledge. One single observation can invalidate a general statement derived from millennia of confirmatory sightings of millions of white swans.The Black Swan: The Impact of the Highly Improbable by Nassim Taleb
The phrase “black swan” was popularized by Nassim Taleb in his 2007 book of the same name and refers to an extreme and unexpected event. I’ve written previously on black swans: Turkeys, Swans, and The Problem of Induction.
To be a black swan, an event must have three elements:
First, it is an outlier, as it lies outside the realm of regular expectations, because nothing in the past can convincingly point to its possibility.
Second, it carries an extreme impact (unlike the bird).
Third, in spite of its outlier status, human nature makes us concoct explanations for its occurrence after the fact, making it explainable and predictable.
Is the COVID19 pandemic a black swan event?
While the pandemic does pass the second and third elements — it is having an extreme impact and we are able to explain its occurrence after the fact — the first element is missing as COVID19 fits well within the realm of regular expectations. Here is evidence, some anecdotal, that this pandemic was predictable or even expected:
Exhibit One: Prior pandemics have occurred regularly:
- The 1918 Influenza Pandemic
- Avian Flu
- Swine Flu
Thus, it makes total sense to expect that others would occur.
Exhibit Two: experts have been saying for years that we should expect a pandemic.
Case in point: this past summer I met an infectious disease doctor who worked at the CDC and Emory Hospital on a snorkeling trip in Hawaii. (She was in Hawaii on her honeymoon and probably wanted to leave the world of diseases far behind but I spent most of our boat ride to our snorkeling spot asking her about pandemics.) She said that a major pandemic was a matter of “when” and not “if” and scared the crap out of me talking about how woefully underprepared our health care system was for such a crisis (as we’re now seeing). I asked her why we weren’t prepared and she cited a lack of funding, the siphoning of resources to treat chronic diseases and plain old ineptitude.
Another data point: this past Friday I listened to a fantastic conference call put on by Entrust Global with Dr. Michael Mina, an epidemiologist from Harvard. Among his many points was that this pandemic is not a surprise and how it has played out is not a surprise. If you’d like to listen to his hour-long call, here’s the call-in information (it should be available until the end of this week):
Dr. Mina replay info:
US Toll free: 1 888 286.8010
International direct: +1 617 801.6888
Finally, the CDC has been warning of a pandemic for many years. In fact, nearly 10 years ago the CDC published this really fun graphic novella about how to prepare for and act during a pandemic using a zombie apocalypse as an example: Preparedness 101: Zombie Pandemic
Exhibit Three: There have been many warnings about a potential pandemic in books and the media
A great example is a fantastic article in The Atlantic from August 2018 titled The Next Plague Is Coming. Is America Ready? From the article:
Even the U.S. is disturbingly vulnerable—and in some respects is becoming quickly more so. It depends on a just-in-time medical economy, in which stockpiles are limited and even key items are made to order. The most common lifesaving drugs all depend on long supply chains that include India and China—chains that would likely break in a severe pandemic. Perhaps most important, the U.S. is prone to the same forgetfulness and shortsightedness that befall all nations, rich and poor—and the myopia has worsened considerably in recent years. Public-health programs are low on money; hospitals are stretched perilously thin; crucial funding is being slashed. And while we tend to think of science when we think of pandemic response, the worse the situation, the more the defense depends on political leadership. The White House is now home to a president who is neither calm nor science-minded. We should not underestimate what that may mean if risk becomes reality.
Other articles warning of next pandemic: Heading Off the Next Pandemic (2010), A Better Response to the Next Pandemic (2010), and The World Knows an Apocalyptic Pandemic Is Coming But nobody is interested in doing anything about it (Sept. 2019). Even the trusty IFOD talked about how to prepare for a pandemic back in 2017: Pandemic Preparedness 101
Books, such as Get Well Soon: History’s Worst Plagues and the Heroes Who Fought Them by Jennifer Wright, warned of the inevitability of a pandemic and provided great lessons for how to handle future pandemics, including this lesson (quoting author John Barry): “Those in authority must retain the public’s trust. The way to do that is to distort nothing, to put the best face on nothing, to try to manipulate no one . . . Leadership must make whatever horror exists concrete. Only then will people be able to break it apart.”
Even in The Black Swan there is a warning about pandemics: “As we travel more on this planet, epidemics will be more acute— we will have a germ population dominated by a few numbers, and the successful killer will spread vastly more effectively.”