In the book of Genesis, Pharaoh, besieged by ominous dreams, called in the experts early.
Joseph, whose reputation preceded him, explained that the seven fat cows followed by seven skinny cows emerging from the Nile in Pharaoh’s dream foreshadowed the seven years of plenty and seven years of famine coming to the land of Egypt. Joseph advised the Pharaoh to set aside one fifth of the nation’s produce in the good times as a reserve for the bad times. Mightily impressed, Pharaoh set about these plans at once, making Joseph his second in command. When the famine came, Egypt was ready.
Of course, dreams are not epidemiological data sets. And divine foresight is not mere expertise. Nevertheless, that stubborn ancient wisdom — that failing to prepare is preparing to fail — remains as a basic principle of government. The fact is that, in our troubled times of COVID-19, politicians were warned of the imminent danger of an epidemic yet did not take the sufficient measures when times were good. The result, now, is a very heavy price.
In 2015, Bill Gates, co-founder of Microsoft, gave a TED talk in which he warned that the greatest risk of global catastrophe in the world today was “not missiles, but microbes” — not nuclear war, in other words, but an influenza virus. “If anything kills more than 10 million people in the next decade it’s most likely to be a highly infectious virus,” he warned. Gates’s concern was that while huge sums had been invested in nuclear deterrents, “we’ve actually invested very little in a system to stop an epidemic.”
These weaknesses had been made obvious during the 2014 Ebola outbreak, during which the Gates Foundation had shipped supplies to help doctors and nurses protect themselves from the virus and prevent its spread. At least 10,000 people died from Ebola. It was only a matter of luck that it wasn’t millions more. Part of this was because the virus became infectious only when people were severely symptomatic and bedbound. Another reason is that it did not make its way into densely populated urban areas. “If there is any good to have come out of the Ebola crisis,” Gates said, “it is that it has acted as an early warning, a wake-up call.” For the weakness it had exposed was not merely “that the system didn’t work well enough” but rather that “we didn’t have a system at all.”
The kind of coordinated response Gates had advocated in 2015 would have made all the difference in the current fight against COVID-19. Many have been invoking war as a metaphor. But in truth, it’s more than that. To have a fighting chance against a pandemic, each country needs an army of health-care workers. In the same way that there are military corps, countries needed to have their own medical reserve corps who, in conjunction with the army, are able to provide an immediate and wide-reaching response in the event of an epidemic. Five years ago, Gates called the absence of such provisions “a global failure,” noting that even the World Health Organization was funded only to monitor these epidemics, not to respond to them. NATO prepares for war with war simulations; why was the U.S. not preparing with more germ stimulations?
One possible answer, of course, is the expense. “I don’t have an exact budget for what this would cost but I’m quite sure that it’s very modest compared to the potential harm,” Gates said in his talk. But even then, the World Bank estimated that another flu epidemic could decrease global wealth by over $3 trillion. That is in addition to the many millions of deaths. “I think this should absolutely be a priority,” Gates said. But who was listening?
COVID-19 was first discovered in China in December. Since then, Europe has watched in horror as Italian hospitals have become completely overwhelmed with a fatality rate of 9 percent. The Spanish army has found care-home residents “dead and abandoned” in their beds. Iran has dug a mass grave visible from outer space. The United States and the United Kingdom have floundered in providing widespread tests and, some experts say, have squandered precious time. Millions of Americans have already lost their jobs. There’s no telling how or when the economy will recover. President Trump has said that he wants to reopen businesses by Easter, but health experts have warned that this would be a grave mistake. Besides, would it even work?
“It’s very tough to say to people, ‘Hey, keep going to restaurants, go buy new houses, ignore that pile of bodies over in the corner, we want you to keep spending because there’s some politician that thinks GDP growth is what counts,” Gates said in an interview this week, while advocating at least a 10-week shutdown. He might also have said I told you so.