7 notes for a pandemic

In the wake of the 2004 Tsunami, I was part of the first UN team to hit the ground in Aceh, where around 200,000 people had just been killed by giant waves.

When Larry King later asked me (live from Aceh) what it was like I answered with one word: “Chaos.”

In watching the slowly unfolding wave of Covid-19 chaos, and the often muddled and contradictory response from governments, corporations, and public health officials, I’ve been quietly telling my friends for weeks that they should prepare for the inevitable. Because so far, I'm just seeing chaos from the Australian government.

In New York in 2003 I sat on a UN Avian ‘Flu Pandemic task force (for a contagion that remained limited). Like war-gaming, the value of this work was in the outcomes it imagined, and in the impossibly tangled series of contributing factors it took into account.

Now, Australia doesn’t lend itself to panic. We fancy that we’re a laconic bunch, untroubled by most of the world’s woes. If you’re lounging on the beaches, playing football, or sitting in a Sydney café it’s a stretch to imagine those activities being banned by government fiat.

But ask an Italian three weeks ago if all schools, transport, offices, shops, and tourists would be shut down by force of law in 21 days, and they’d have thought you pazzo (crazy). This blog is not advocating panic, but perception.

The mistake of those who resort to comforting simplistic platitudes like “it’s just like seasonal ‘flu” is that it misses the point that this is not the ‘flu, our health systems are not financed to deal with double seasonal disasters, our people and government are not prepared to face Covid-19, and the rapid overrunning of Italy’s excellent health care system (yes, Italy also had the ‘flu this winter season) is a case in point.

That 2003 UN task force knew that the emergence of a viral storm with the disruptive effects and potential mortality figures of the 1918 Spanish ‘Flu was a certainty. What was not certain was the extent of the damage it would inflict – how would it spread, how many would die, and how could deaths be limited?

1. Chaos doesn’t = panic. The false reassurance issued by some world leaders that there’s no cause for Covid-19 panic is misleading. People have a herd instinct for danger. Uncertainty breeds panic unless that very sense of uncertainty is clearly shared and communicated by a leader. 
2. Chaos is, er... complex. This is not just about a malevolent bug. As we have seen from the very different circumstances, responses and success rates of countries such as China, Singapore, Italy, the US, and Iran, the successful management of Covid-19 depends on the characteristics of the virus (transmissibility, lethality, mutability); the characteristics of health and political systems; the quality of leadership; and public communications that shape perceptions and reinforce public response.
3. One thing works for sure. If the virus can’t reach a person, that person can’t be infected. Quarantines, public hygiene, cordons sanitaires, (the secluding of a population that is not necessarily infected) and general awareness all limit transmission.
4. Collective action limits risk. Each percentage point gained in reducing risk is a win for the limited public resources (hospital beds and ventilators). Everybody has a small, practical role in reducing that risk.
5. Control the message. One of the smartest responses to Covid-19 is Taiwan’s issuing of an official app. At the very least, all countries should have an official single source for current events, best practices, emerging intelligence, and official advice and directives (Telling people that you’re going to the footy is simply not the message that is needed).
6. Communication is action. Good health communications is about action. Sydney still has no nodal hygiene points on railway stations, or at supermarket teller points or bank automatic outlets. Hygiene stations telegraph that somebody’s in charge.  They reinforce vital messages about social distancing, clean hands, and the shared responsibility of a public health crisis, and they promote public calm.
7. Chaos brings opportunity. We will be much wiser after this event, and much better equipped to deal with the certain emergence of future viral storms. Covid-19 is testing systems that have never been tested before, and creating new systems we never imagined possible, such as the massive open-source cross-pollination of scientific intelligence as brilliant scientific teams rush to find solutions.

Finally, this will pass. The first wave (and the first month or two) is the most lethal in every country because it catches us unaware (which is why we talk about "flattening the curve"). Public immunity will gradually build. Later on, the virus might mutate into a worse scourge, shifting its characteristics, but we’ll likely be better prepared. A country that handles this early on through overwhelming suppression will emerge earlier from the pandemic, and be better positioned to return to work discrete segments of the workforce which can be effectively surveilled by a functioning healthcare system. So don’t panic, but do change your perspective, because everybody has a role to play in this unfolding viral storm.