With the turn of the calendar there is always both hope and anxiety about the year ahead. This is nice because it gives pundits and bloggers something to write about. Just before Christmas The Times of London published\ a “leading article” (unsigned), Black Swans and Bird Flu, which was about the anxiety part, assessing the threats, and planning for them in advance:
Living at risk, it has been said, is akin to jumping off the cliff and building your wings on the way down. Not everyone would be content with such a strategy. Some would not venture close to the edge, even if that meant missing a discovery or a thrill. Others would insist on constructing wings in advance and keeping them nearby just in case they might be needed at short notice.
Sir David King, the Government’s outgoing Chief Scientist, is clearly and understandably in the second category.
[His major concerns are climate change and] the possibility of a global flu pandemic — triggered by the emergence of a strain of bird flu which could easily be transferred to humans. This, he gives warning, would spread rapidly from South-East Asia on to Europe.
Despite this chilling thought, his view of risk remains optimistic. Sir David believes in what Donald Rumsfeld famously labelled “known unknowns”. Climate change and a bird flu pandemic are dangers that officials appreciate could happen. The policy argument consists of how large a risk they constitute and what should be done and at how much cost to alleviate the chance of their occurring.(TimesOnline).
Fine, the editorial says, but what about the alternative point of view? History is not made by the “known unknowns” but by the “unknown unknowns,” the bolts out of the blue like 9-11 that were unforeseen but “change everything.” These unimagined “black swans” are the leit motif of history, not the imaginable things we are merely uncertain about. They are, by definition, impossible to predict. Maybe there will be a pandemic, but history teaches us it isn’t likely to be the one we expect.
The TImes has a sensible take on this, as far as it goes:
The difficulty with the black swan concept is that it can acquire nihilistic characteristics. It can be taken to mean that climate change and bird flu should not be addressed because something else will arrive in their place. Risk becomes an Act of God rather than an area of life in which calculations of probability have any utility. This is too sweeping. Unknown unknowns may be more devastating than known unknowns because of their shock value. This cannot mean that known unknowns have never manifested themselves or been prevented because they were anticipated. Would we be comfortable if Sir David revealed that he had not bothered to commission antiviral drugs because they might not be effective against the pandemic that emerges? Those who leap off cliffs would be wise, as far as possible, to have those home-made wings at close quarters.
There is, I think, more that can be said. Instead of preparing for an imagined Big Bad Wolf, why not do as the wisest of the Three Little Pigs did, build a strong brick house that will protect us against the Wolf, the Wolf’s cousins and the worst of bad weather as well. That means — yes, I’m going to say it again — strengthening our public health and social service infrastructures so that we have more resilient, more robust communities. Why try to predict the exact catastrophe and prepare for it by depending upon catastrophe-specific measures, like an antiviral that works for flu but not for other diseases or natural events? Why not a stronger, tidy little brick house instead of the Don Rumsfeld Memorial Charnel House in Iraq with money we could have used to keep Americans safer at home. We’re fighting them there so we can’t fight disease here?
We have talked quite a bit here about how much we don’t know about influenza and how so much of what we thought we knew has turned out wrong. We are, in effect, predicating much of our preventive measure strategy on a pretty shaky knowledge base, Rumsfeld’s “known unknowns.”
Maybe now that Rumsfeld and his insane boss have started the United States on a long period of decline, he could come back for one last Black Swan Song and run the influenza preparedness program. Then he could take full charge of the only category he didn’t mention but at which he was a master: the things we think we know but are wrong about.