Big Chaos Big Change Series: Part 4, Pandemics
Pandemic Perspective & Possibilities In Light Of Covid-19, Culture Wars, Politics, Institutional Damage, & The Threat Of Bird Flu
A Big Picture Take On An Overwhelming Topic
I don’t like talking or writing about big, complicated disasters like I’ve been doing for the last week. I don’t.
I suspect most people don’t like reading or talking about big, complicated disasters either.
I have this suspicion because I’ve watched people’s eyes glaze over when I’ve talked about big disaster stuff since I’ve worked in this field… but mostly because big disasters are just freaking overwhelming.
Big disaster stuff is overwhelming.
Major pandemics are worse.
Major pandemics are worse of course because they can involve such enormous and widespread suffering and death. Major pandemics are also worse because they involve enormous scales of things that are deeply intertwined and interconnected. Major pandemics are very hard to track and to understand; as a human.
This post is written to help people generally understand the current readiness (or not) of the US for another major pandemic.
This post is intended to be a big picture distillation of a very complicated set of things. It’s written from the unique perspective of a person who has worked within some of these systems and who tried to get some of them to work better from the inside.
This post is not an exhaustive look at all the things that went wrong with the Covid-19 (SARS-CoV-2) response in the US — nor is it an exhaustive look at all the possible things that could go wrong next time. This post is a very high level look at critical big picture factors that could be troublesome in the next major pandemic.
It is very easy to get lost in the weeds (details) when it comes to big chaos. Stepping back can help us better navigate chaos when it happens, to survive that chaos, and to make change from within it. That’s this series — big chaos and big change.
Big Systems & Wicked Problems
Both “normal” disasters/catastrophes and pandemics involve systems of systems; system interdependencies; system disruptions; and cascading effects of all the things.
Major pandemics are larger and more system-oriented than “normal” disasters and “normal” catastrophes. Pandemics include more things like feedback loops and exponential/nonlinear growth of disease spread and so on. As a sidenote, many of the systems factors that are present with major pandemics are also present with the complex problem of climate change as well but obviously in different ways.
Disasters, pandemics, and climate change are huge, nonlinear, complicated things that could also be considered “wicked problems.” Wicked problems are those that are “difficult or impossible to solve because of incomplete, contradictory, and changing requirements that are often difficult to recognize” that have “no determinable stopping point.”
Pandemics are a sort of wicked problem; they will always be harmful.
We could make them less harmful, though — that’s why it’s worth thinking through how we respond to them (or how we fail to).
Covid-19: The Current (-Ish) Pandemic With A Low Mortality Rate
Our most recent and perhaps current pandemic has been the Covid-19 pandemic — which some argue has changed from pandemic to endemic. A decent article on the topic this week notes that “Some epidemiologists say COVID may be on the way to becoming endemic, but the virus is still too unpredictable to reach that conclusion yet. This summer’s surge, for example, started surprisingly early and is turning out to be significantly bigger than expected. The latest data from the CDC shows high or very high levels of the virus in wastewater in almost every state.”
Whether or not it’s still a pandemic, the Covid-19 mortality rate has been very low. That’s helped us keep lots of parts of society and civilization intact.
The Covid-19 mortality rate was never very high, decreased once populations were able to access vaccines, and remains low today. This Johns Hopkins University page indicates that the current-ish US mortality rate for Covid-19 is right around 1%. That means that approximately one person out of every 100 who are infected dies of the infection. The CDC reports today that the official total US deaths since January 1, 2020 from Covid-19 are around 1,196,526 people. That’s a heck of a lot of people; even with a very low mortality rate. We’re undertesting, so the mortality rate could be a bit higher; yet it’s not likely to be massively higher or we might be behaving differently. The Covid-19 disability rate is much higher than the mortality rate. The disability rate is harder to determine — and also doesn’t seem to terrify people in the same way that a mortality rate does (or doesn’t).
Worldwide, the majority of humans are not behaving in ways that indicate that they’re terrified of Covid-19. In other words, people overall are not behaving in ways that would mitigate their risk of getting a Covid-19 infection. Low human mortality rates worldwide is part of why.
A higher mortality rate might have changed how we have responded to Covid-19 from the beginning.
That fact alone does not set us up well for the next pandemic — because the public’s loose perception of the current disease threat is that it’s probably not too bad and probably won’t kill you. Of course, that doesn’t mean the next disease will be the same.
Which brings us to…
Bird Flu: A Possible Next Pandemic
Perhaps the most likely next pandemic is bird flu. One never knows, but the science sure gives us some ideas.
Bird flu may also be referenced as Highly Pathogenic Avian Influenza (HPAI), as avian influenza, as H5N1, or as A(H5N1) to delineate Influenza A of the H5N1 type.
There are many ways to give big picture information on bird flu — we’ll do only a few here. News sources, public health experts, epidemiologists, and so on would also be good sources.
Here’s the most recent official summary from the CDC’s Bird Flu Response Update dated August 9, 2024:
“Systematic comparisons of data related to this avian influenza A(H5N1) virus… has scored this virus's future pandemic potential as ‘moderate’ based on information through June 26, 2024. This is similar to previous assessments of earlier avian influenza A(H5N1) viruses.”
That CDC situation report references the August 9 Results of Influenza Risk Assessment Tool posted here. Check these official CDC pages for more details and updates.
USDA is posting some avian influenza information here. USDA is essentially the federal government department on the front lines of bird flu; actively working with states, local governments, and farmers to test and to eradicate (kill) infected animals and/or herds when identified (among other things). They are working with other government agencies including the CDC to coordinate testing of human workers exposed to the virus. I did not immediately find a public USDA situation summary; I doubt there are public versions. Widespread testing and eradication of farm animals is a touchy subject for all kinds of reasons. Talking about an animal epidemic with potential human health implications is touchy, too. Talking about impacts to the US or worldwide agricultural economy is also touchy. All of the related politics are touchy as well; especially in a high-stakes presidential election year.
Even so, the USDA and cooperators are (hopefully) moving aggressively on this issue to mitigate both the animal health threat and the related human health threat. It’s a very tough situation. We may or may not be handling it as aggressively as we need to be on the farm front.
As my Grandmother would say, “Time will tell.”
So yes — if we end up with a worldwide bird flu pandemic because of virus mixing on US farms, time may well tell us that.
But virus mixing and evolution could occur in all kinds of places worldwide.
Here’s an an unofficial bird flu summary — this “Bedtime Story” bird flu post by Sharon Astyk, who is a writer and community-builder encouraging people to get ready for big chaos such as we’ve been talking about here. The “Bedtime Story” post is an excellent big picture summary of the story arc on H5N1 bird flu since it first showed up in 1997. I share that post because it’s an excellent summary, and because Ms. Astyk’s work tends to be thoroughly researched and well-assembled although I can’t verify that it’s 100% accurate. Who can? One of the problems with “wicked problems” such as a large and uncontrolled (not the official term) animal health epidemic is that it’s hard to figure out or keep track of all the things that are happening. You have to stay pretty on top of lots of decent sources to keep up-to-date; Ms. Astyk is doing and sharing that more than many other people are right now.
One key point from the “Bedtime Story” post:
“Over the last three years, though, there has been a fundamental shift. Besides moving into more and more species of wild birds on almost every continent, it spread into more and more kinds of mammal than it had ever been able to infect before, and then spread between them.”
Lots of folks are making predictions about whether bird flu could become a human pandemic (even the CDC rates the possibility as “moderate”), but the biology brings us to tough realities: bird flu is recognized to be endemic in wild birds; it has moved into mammalian populations; it can infect humans; and it could evolve to spread human-to-human (H2H) at some point soon or in the near future. Bird flu is already moving very effectively between cows who are becoming infected by other cows and not just by wild birds. Humans recently infected with bird flu seem to be catching it from working with infected poultry or cattle populations.
The more the virus mixes up between species and the more it infects humans the more likely it is to evolve into something that can spread quickly human-to-human.
Human-to-human bird flu spread would be bad.
It is important to note here for maximum clarity that H5N1 (bird flu) has not yet evolved into a virus that can spread between humans and infect them. The CDC’s August 9 bird flu response update noted that “based on the information available at this time, CDC's current assessment is that the immediate risk to the general public from H5 bird flu remains low.”
To recap, CDC says the pandemic risk from bird flu is “moderate,” but that the current immediate risk to the general public is “low.”
For now.
If bird flu does evolve to spread human-to-human, we could see very high mortality rates. Humans have been tracking this disease since 1997 so there is some limited data on human mortality rates.
In the “Bedtime Story” post cited above, Ms. Astyk noted that the human bird flu mortality rate could be as low as 20%, “a compromise between Redfield and the WHO’s [World Health Organization’s] estimates,” but that “the death rate among young children is higher — nearly 40%.” She added that “at least 1/3 of surviving patients require hospital ICU care.”
Those are some very, very, very, very, very high potential human mortality rates.
Very high.
Because bird flu has not yet (thankfully) infected millions of humans, it’s hard to tell what the human mortality rate would actually be. The estimates above are a reasonable guesstimate, and less terrifying than the WHO numbers collected here in a table which put the bird flu mortality rate at roughly 50%. Yikes, to say the least.
With a potentially very high mortality rate, bird flu could have a spectacular impact on our society and on our civilization as a whole.
Everything would be different. Everything.
Adding complexity, this 2020-2024 avian influenza summary on Wikipedia notes that in the US in 2024, “it was also shown that asymptomatic cows could spread the disease” (also referenced here). That’s not good. It indicates that at least in cows, bird flu can be spread between asymptomatic individuals. If the virus maintained that asymptomatic spread feature if/when it spread into humans, it would spread so much faster for a huge array of reasons.
Bird Flu & Civilization
In my first winter at DHS in 2005-2006, I worked in what is now the Cybersecurity & Infrastructure Security Agency (CISA). I served as and worked with the team of Infrastructure Sector Specialists who served as key government liaisons to the 16 critical infrastructure sectors as identified by the US government.
We did an internal team table top exercise (TTX) on bird flu as it was beginning to surge in a few parts of the world.
For our exercise (TTX), we used a death (mortality) rate of about 30% — going with the estimate that approximately 1/3 of those infected would die (hypothetically; it was an exercise). But well more than 30% of people who run infrastructure (and society) would likely be taken out-of-service in such a pandemic — because lots of people would be terrified, infected, sick, quarantined, or caring for loved ones. For the purposes of the exercise, we therefore increased the hypothetical number of people taken out-of-service from their jobs to something closer to 50% (although I don’t remember the specific number).
Um, that exercise didn’t go well — hypothetically, for our hypothetical society.
One thing about system science and pandemics is that it’s hard to work through hypothetical scenarios very far out (like even 2-3 days) without running into quite a lot of chaos and unknowns because of exponential growth, negative and positive feedback loops, interdependencies, and cascading effects of various effects. There’s a great interview from around 2020 or 2021 with someone who said similar and who had been involved in US government pandemic planning at the White House level. If I can find the video, I’ll add it to this post later.
But imagine these questions….
How can you keep the electricity on when more than 1/3 of people who run the power grid and the generating stations may be dead… and when others don’t or can’t show up for work because they’re terrified, infected, sick, or caring for loved ones? Can you, in fact, keep the power on if something like 50% of the workforce isn’t there?
Same question for the water systems.
Same question for hospitals and health care systems which would be critical to keeping at least some of us alive in a pandemic.
How does the supply chain function when 1/2 of transportation system operators and administrators are terrified, infected, sick, dead, etc.?
And so on.
So, yeah… bird flu could go not well at all for keeping society functioning in the ways in which we prefer and expect society to function. And that’s just one pandemic scenario.
Infrastructure has interdependencies. When infrastructure fails, there are cascading effects. It’s hard to keep water systems on without electricity. Hospitals have generators in case the power goes out, but those depend on fuel which depends on supply chains. Everyone depends on food. Most of us depend on the supply chain for food. Food can’t be produced if 50% of the people who produce food are out-of-service. And so on.
The Human Continuity Project — It’s A Thing
As an aside, it’s worth noting that at least some critical infrastructure owners and operators have figured out that society and civilization are really pretty vulnerable; because we’re so dependent on our interconnected critical infrastructure systems. The energy sector is one of 16 critical infrastructure sectors in the US. One of the groups involved in that sector, the Electric Infrastructure Security Council (EIS Council), has put together work on something called “The Human Continuity Project.” From the website:
“Humanity is facing growing challenges to the complex, vulnerable network of interdependent infrastructures that sustains our lives, risking irreversible, systemic disruption of modern civilization. Leading academic and research institutions, corporations, foundations and government agencies from across the globe are coming together to address this risk.”
I mention this to provide some external validation that real damage to big, critical infrastructure in a pandemic or in major catastrophes is huge big deal and presents a very real challenge to civilization as we know it. The EIS Council is taking on this human continuity issue for the same reason that this nonprofit (Shift the Country) is writing a Big Chaos post series: we’re better able to handle big crises if we think through them ahead of time and put things in place to make the crises less bad.
Back to pandemics.
The Next Pandemic Could Be Worse Than Covid-19 — Biologically
Bird flu is not necessarily going to be the next pandemic. The next pandemic could be something that materializes fast and moves fast and that we don’t even know is coming. The next pandemic could also potentially come from some sort of evolution of known diseases that combine with each other or that evolve in a way that makes them more dangerous than they currently are. Could be bird flu. Might be something else entirely.
Whatever the next pandemic is, it may well have a much higher mortality rate than Covid-19.
Whatever the next pandemic is, it may spread asymptomatically (like bird flu is doing in cows) — which would make it very hard to track and to mitigate exposure to.
Past human and disease histories are not good predictors for when and where the next pandemic will come from. We may well have another more severe pandemic quite soon even though covid only started in 2019. Our planet is evolving faster and in different ways than ever before. We have a growing world population living increasingly in densely populated high disaster hazard zone locations that could contribute to disease mixing, evolution, and spread. We have increasing human incursion into and exploitation of wilder areas. We have climate change happening which is expected to bring increases in human disease; including pandemics.
Institutional Damage, The Culture War, & Politics
The US’ pandemic response capacity was not fabulous before the Trump Administration. It was worsened during the Trump Administration. The US pandemic response capability prior to the Trump Administration has not been fully restored and there is still institutional damage. Culturally and politically there is other damage to our collective US pandemic response and mitigation capability. As a country, we have also not made large-scale post-covid-pandemic changes that incorporate after-action knowledge about problems that occurred, systems that didn’t work, problematic laws, etc.
This section may be the densest part of this post. The rest of it is done in bullet points for efficiency.
Challenging recent & current aspects of US pandemic preparedness & response:
The US worked on creating a robust, national, interagency pandemic response during both the George W. Bush and the Obama Administrations — due to recognized pandemic threats from many sources.
The Trump Administration deliberately dismantled elements of the two prior administrations’ federal and national pandemic preparedness, mitigation, and response systems before and during the Covid-19 pandemic.
The Trump Administration actively blocked or went around many elements of US pandemic response systems, policies, and laws during the Covid-19 pandemic.
The US has current pandemic plans that are part of the overall National Preparedness System, including multiple National Planning Frameworks and corresponding Federal Interagency Operational Plans (FIOPs). These were in place for use during the Covid-19 pandemic but were not used to their maximum extent due to workaround actions and/or blocking by the Trump Administration.
There is a Biological Incident Annex to the Response and Recovery Federal Interagency Operational Plan posted to the FIOP page: a 230-page supplement with specifics for pandemics and other biological hazards. It was updated in May 2023 to account for some of the developments from the Covid-19 pandemic. This annex was in place for use during Covid-19 but was not used to its maximum extent due to actions and/or blocking by the Trump Administration.
Even with these plans and systems, the US still has 10+ resource mobilization and mutual aid systems and no formalized national coordination system to coordinate, prioritize, and adjudicate conflicts between the systems. The existence of these systems was a huge challenge during the initial two years of the Covid-19 pandemic. During that period, the Trump Administration created workarounds and backchannels; most of which created additional resource competition and inefficiencies. These 10+ resource systems were a complicated mess before the Trump Administration and remain a mess today; they will contribute to complications for any future domestic pandemic response.
Congress has not addressed or changed the myriad of policies and laws identified as problematic or ineffective during the Covid-19 pandemic in serious ways and at scale.
The Trump Administration actively created corrupt private sector mechanisms to go around federal response/mobilization mechanisms in order to help their connections make money during the Covid-19 pandemic.
There are indications that the Trump Administration mobilized critical Covid-19 pandemic resources to locations, states, or parties that curried favor with the administration and/or allowed government assets to be distributed for profit.
The Trump Administration used the Defense Production Act in ineffective ways or in ways that could curry favor with particular industries during Covid-19 rather than to most effectively protect the health and safety of Americans; the DPA was used in some ways that actively endangered certain Americans.
The Trump Administration did not follow best practices or use established laws and mechanisms for managing a public health emergency during Covid-19; in many cases it created dangerous precedents that remain in place yet are ineffective for mitigating or responding to a public health emergency.
State and local governments in many cases actively created new channels or approaches for pandemic response due to issues with the federal government’s Covid-19 response or lack thereof.
Federal institutions responsible for pandemic and disaster response/preparedness were damaged during the Trump Administration’s efforts to dismantle or block certain actions. Some of these changes and policies likely remain in place in the form of executive orders, policy changes, office dissolutions, and agency reorganizations. It is not clear that the Biden Administration has done a whole-of-government check across agencies to restore effectiveness since the end of the Trump Administration.
Trump Administration political appointees involved in the damaging/counterproductive Covid-19 federal response may remain in the federal government in political appointments, or may have “burrowed in” to permanent federal employee positions. These remaining individuals may be continuing counterproductive, inefficient, or corrupt approaches used by the Trump Administration during the Covid-19.
The Biden Administration has not been proactive with public health education efforts or with specific measures that could help mitigate the spread of Covid-19; for example through more aggressive CDC guidance. These factors contribute to ongoing domestic Covid-19 infection and spread, and to Covid-19 deaths and incidences of disability.
Challenging culture war & political factors impacting current US pandemic preparedness & response:
Donald Trump, the Republican party, and an associated right-wing media empire have created and amplified a culture war against all public health disease-spread mitigation measures and against many elements of related science and medicine.
There has been institutional public health damage at the state and local level in many locations due to the cultural pushback against public health. Public health regulations, funding, staff, and offices have been removed at several levels. Public health measures/provisions that mitigate/prevent disease spread have been outlawed in states and localities. These places are likely to see the highest numbers of deaths, infections, corresponding infrastructure failures, and corresponding economic damage in case of a new public health emergency; especially if the new pandemic has a higher mortality rate than Covid-19.
There is now a hyperactive right-wing media empire and corresponding segment of the US population that’s likely to ignore or push back against any public health mitigation measures in any new public health emergency such as a high-mortality bird flu situation. Again, these populations are likely to see the highest levels of infection and death when a new public health emergency arises due to resistance to any disease spread mitigation measures; willing and flagrant exposure to disease risks; potential vaccine refusal; and willing and intentional science denial.
High levels of misinformation, disinformation, and propaganda will further complicate future public health education and disease spread mitigation efforts as well as vaccine intake and effectiveness.
The US Congress has not been proactive recently with funding or measures that could help mitigate the spread of Covid-19 or that could help us respond more effectively to it. These factors contribute to some ongoing Covid-19 infection and spread, and to Covid-19 deaths and incidences of disability.
Trump, Vance, and the current Republican party want less government; less capacity to respond to catastrophes; and more chaos in which they can seize or consolidate power. This was demonstrated through the Trump Administration’s willful Covid-19 pandemic response obstruction that led to the deaths of hundreds of thousands of Americans, and through actions that pushed an extensive culture war against public health.
The 2024 election will be critical to determining how the US handles future pandemics.
We can do a better job of getting ready for and responding to pandemics. Part of doing better is understanding what’s not in place now. Part of doing better is imagining more realistic pandemic scenarios and putting more things in place so we’re more ready. Part of doing pandemics better is imagining more creatively how we can do government and society differently so we do a better job at taking care of people and making sure more of us survive, thrive, prosper, and flourish through the next one.
Making Big Change — Through Big Vision
This Big Chaos Big Change series was written to help us understand what we’re facing in this intensifying era so that we can —
Get through this time of transformation better,
Have a better sense for the chaos we might need to deal with as we go, &
Think about how we can build systems for the future that will help us better survive, thrive, prosper, and flourish even in light of a very challenging risk landscape.
Anyone can have big vision events in their communities this fall where we get people talking about the future we want. Get started on the Make Shift Happen page.
It’s a great way to drive civic engagement, public pressure, and voter turnout to create a more equitable, resilient, and sustainable democracy. It builds on the big vision Harris/Walz campaign momentum, too.
You can also invite Shift the Country to speak to your group — or set up a call to explore ways to get shift going. Email team@shiftthecountry.com. Call (515) 375-9027.
There’s not another organization like this. Shift the Country is uniquely structured for the challenges in this transformative time.
Keep your wits about you, and keep the faith — in all of us.
Let’s do this shift.
Vanessa Burnett is the Executive Director of Shift the Country, a unique nonprofit set up to drive civic engagement, public pressure, and voter turnout to create a more equitable, resilient, and sustainable democracy. Vanessa is a former homeland security professional with 25+ years experience in resilience, big disasters, wildland fire, emergency management, land management, continuity of operations, and disaster information sharing.