The developing world will be swept by a series of viral epidemics that will eliminate most of the population. These plagues, however, will fail to devastate the more affluent developed world.
However, in the developed world, people with compromised immune systems -- the sick, the very young and the elderly -- will be subject to constant fatalities from antibiotic-resistant bacteria.
My new prediction:
Antibiotic resistance will have epidemic-like consequences for all age groups; moreover, this will happen all over the world, not just the wealthy developed world.
All this will happen around 2100, when the world population begins to decline.
The new information:
The overuse of antibiotics in agriculture globally has created antibiotic resistance all over the world, not just in the USA. Also, global warming has played an unexpected role.
https://www.nytimes.com/2019/04/06/health/drug-resistant-candida-auris.html
Last May, an elderly man was admitted to the Brooklyn branch of Mount Sinai Hospital for abdominal surgery. A blood test revealed that he was infected with a newly discovered germ as deadly as it was mysterious. Doctors swiftly isolated him in the intensive care unit.
The germ, a fungus called Candida auris, preys on people with weakened immune systems, and it is quietly spreading across the globe. Over the last five years, it has hit a neonatal unit in Venezuela, swept through a hospital in Spain, forced a prestigious British medical center to shut down its intensive care unit, and taken root in India, Pakistan and South Africa.
Recently C. auris reached New York, New Jersey and Illinois, leading the federal Centers for Disease Control and Prevention to add it to a list of germs deemed “urgent threats.”
The man at Mount Sinai died after 90 days in the hospital, but C. auris did not. Tests showed it was everywhere in his room, so invasive that the hospital needed special cleaning equipment and had to rip out some of the ceiling and floor tiles to eradicate it.
“Everything was positive — the walls, the bed, the doors, the curtains, the phones, the sink, the whiteboard, the poles, the pump,” said Dr. Scott Lorin, the hospital’s president. “The mattress, the bed rails, the canister holes, the window shades, the ceiling, everything in the room was positive.”
C. auris is so tenacious, in part, because it is impervious to major antifungal medications, making it a new example of one of the world’s most intractable health threats: the rise of drug-resistant infections.https://www.bbc.com/news/health-49170866
The drug-resistant fungus, Candida auris, was only discovered 10 years ago, but is now one of the world's most feared hospital microbes.
There have been outbreaks across the world, and new research shows higher temperatures may have led to an increase in infections.
Most fungi prefer the cooler temperatures found in soil. But, as global temperatures have risen, C. auris has been forced to adapt to higher temperatures.
This may have made it easier for the fungus to thrive in the human body, which is warm at 36C to 37C.https://www.cnn.com/2019/04/09/health/candida-auris-fungus-drug-resistance/index.html
When it comes to bacteria, drug-resistant infections affect 2 million people a year in the United States, killing at least 23,000, the CDC says. And drug-resistant infections more broadly could claim 10 million lives per year around the globe by 2050 -- up from today's 700,000, according to one estimate.
"We live in a world covered with antibiotics," Chiller said. "We really need to be thinking hard about how we use those drugs."When will deaths from viruses and bacteria reach reach epidemic proportions?
Perhaps we can get clues from the past.
The plague of 1347
When the human population shrinks under economic and environmental stressors, humans become vulnerable to epidemics. That is what happened in the 14th century.https://en.wikipedia.org/wiki/Black_Death
The Black Death, also known as the Great Plague or the Plague, or less commonly the Black Plague, was one of the most devastating pandemics in human history, resulting in the deaths of an estimated 75 to 200 million people in Eurasia and peaking in Europe from 1347 to 1351.
The Black Death is estimated to have killed 30% to 60% of Europe's population.[7] In total, the plague may have reduced the world population from an estimated 450 million to 350–375 million in the 14th century.[8] It took 200 years for the world population to recover to its previous level.One curious thing is that Europe's population was already shrinking when the plague struck around 1350.
https://www.economics.utoronto.ca/munro5/L02MedievalPopulationC.pdf
https://en.wikipedia.org/wiki/Little_Ice_Age
The new plagues will strike in 2100 ( ... or 2055?)
World population is expected to peak in the year 2100 at 11 billion people. In these conditions, there will be increased resource scarcity coupled with shrinking demand, an economic double whammy of less supply and less demand. The large number of retirees in relation to the population means strained finances, both nationally and at the household level. (While increased immigration might seem like an obvious remedy, in conditions of economic stagnation, people tend to become more averse to immigrants.) Women will in that case will fill the vacuum by making up a greater part of the workforce, altering social norms. Fewer children means greater investments in education per child. Fewer children also means the extinction of the extended family which currently serves as a social safety net. Fewer young people means less creativity.https://www.theatlantic.com/family/archive/2019/07/world-population-stop-growing/595165/
All of this is now happening in Japan. Japan is a demographic postcard from the future.
https://www.nytimes.com/2019/08/03/world/asia/japan-single-women-marriage.html
https://www.nytimes.com/2017/11/30/world/asia/japan-lonely-deaths-the-end.html
https://www.bbc.com/news/stories-47033704
According to a 2014 report by Deutsche Bank, world population will peak at 8.7 billion people in 2055. In this scenario, peak population and its consequences would happen globally within a generation.
https://www.cnbc.com/id/101018722
If population decline and all that goes with it (e.g., economic contraction) can be connected to the rise of epidemics, then one might expect that Japan is at greater vulnerability for epidemics. Japan is therefore an important test case as a classic developed country losing population and suffering from chronic economic stagnation. However, in the past thirty years of Japanese economic torpor, Japan has not been laid waste by an epidemic. With a highly advanced economy, Japan is insulated from an epidemic by superior technology and a superior healthcare infrastructure.
Perhaps another reason that Japan's population remains healthy despite Japan's economic malaise is because Japan is all about social cohesion. The characteristics that allow Japan to function as a clean, efficient society in the face of crisis -- the willingness of the Japanese to work themselves to death, to tolerate a system in which promotion is based on seniority and not merit, to cooperate with one another, to be so obedient to authority -- are all examples of Japan's national social contract that assures every social group that they will not be forgotten and will be taken care of. Again, this social contract gives Japan the unique ability to function even as its economy frays, but Japan is transforming into a more atomized society with its low birth rate, and the consequence of this for future generations is a society that has much less social cohesion. When Japan's social fabric and economy both begin to fray in the future, then Japan may become much more vulnerable to pandemics.
(In the 2007 documentary "Young Yakuza", a Yakuza boss describes young Japanese as "aliens" who listen to rap music. For the young Japanese men in the film who drop out of society and profess to only care about their personal "freedom", the brotherhood of the Yakuza has no appeal. The documentary illuminates how those angry young men who reject a life in the Yakuza are much more disturbing than the violence and criminal activity of Japanese organized crime. The direction of social change in Japan might be toward this kind of unfulfilling and disengaged individualism.)
["Young Yakuza", 2007 documentary, trailer]
https://mubi.com/films/young-yakuza
Of course, this thesis -- that epidemics will begin to afflict humanity as the world population falls in 2100 -- ignores the impact of climate change on the economy, and how climate-related economic crises would diminish the human population and foster the conditions in which epidemics would arise. That is, my pet theory overlooks the climate-change aspect of the 14th century plague that inspired the theory. I blithely ignore the effect of climate change in my model because the effects of climate change are a big unknown -- a "known unknown", to those who recognize the reality of climate change, and an "unknown unknown" to the rest of society -- whereas the ongoing decline in global population that will create economic and societal conditions similar to contemporary Japan is more predictable. So this analysis is really based on the current Japan scenario, not the 14th century Black Death scenario. (My approach is reminiscent of the joke about the drunk who lost his keys in the dark, so he crossed the street to search for his keys under a street lamp.)
Another problem with my theory is that it compares apples and oranges in comparing the distant past and the distant (and not-yet-existent) future. Various stressors like war, taxes and climate change were already driving down Europe's population in the 14th century, and the Black Death was simply one more factor afflicting an impoverished, overpopulated western Europe. In contrast, current population decline is based on dramatic improvements in the human condition all over the world. My theory relies on the rise of stressors that are expected to arise in 2100 in a world that will be much more developed than today.
Also, it is foolhardly to even attempt to predict the future. Nassim Taleb points out that the defining events in human history were fundamentally unpredictable, despite bogus later attempts to explain them away as perfectly understandable and logical. Instead of pretending to understand and master risk, societies should focus on reducing their vulnerability to risk (e.g., by avoiding debt) in order to minimize damage when the totally unpredictable devastating event inevitably does happens.
https://en.wikipedia.org/wiki/The_Black_Swan:_The_Impact_of_the_Highly_Improbable
The Black Swan: The Impact of the Highly Improbable is a 2007 book by author and former options trader Nassim Nicholas Taleb. The book focuses on the extreme impact of rare and unpredictable outlier events — and the human tendency to find simplistic explanations for these events, retrospectively. Taleb calls this the Black Swan theory.
A central idea in Taleb's book is not to attempt to predict Black Swan events, but to build robustness to negative events and an ability to exploit positive events. Taleb contends that banks and trading firms are vulnerable to hazardous Black Swan events and are exposed to losses beyond those predicted by their defective financial models.Further defying Taleb, one can venture to guess how many people will die in the coming plagues.
How many people are going to die in the plague(s) of 2100?
What portion of a population might be lost to an epidemic? One might assume that death rates are inversely proportional to the level of economic development. Economic development is also inversely proportional to birth rates. So fertility rates might indicate how many people would perish in an epidemic.https://www.un.org/en/development/desa/population/publications/pdf/fertility/world-fertility-patterns-2015.pdf
- global fertility rates average about 2.5 children per family
- African fertility rates average 4.7
- Asian rates are 2.2
- Europe is 1.6
- Latin America and the Caribbean are 2.2
- North America is 1.9
If one multiplies current fertility rates by a factor of ten, one gets an idea of what the future may hold in store. In that scenario, 47% of the population of Africa would perish from epidemics, 22% of Asians would perish, 16% of Europeans, 22% of Latin Americans, and 19% of North Americans.
Because the economies of developed societies are based on specialized skills cultivated through formal education rather than generalized skills taught by the family, the long-term effects of epidemics might be just as challenging for developed societies than on less developed societies. For example, a country like Afghanistan might lose one-third of its population to war and disease, but because most Afghans are farmers with high birth rates, within a generation the population can bounce back from a population implosion. In contrast, in countries like the USA, people tend to have specialized skills, so the loss of ten percent of the population would be economically crippling, perhaps permanently. (For example, it takes about 25 years of fancy book learning to train a PhD.)
The world's population may peak and start to fall somewhere between 2055 and 2100. That is not so far off in time (most students in college today will probably still be alive in 2100). But that is time frame of when the plagues are going to hit.
Systems that are safe after failing
In the popular mind, a "fail-safe" system is one that can withstand anything thrown at it. This is an incorrect notion. Actually, fail-safe refers to a system that will minimize damage or disruption when it does fail. (This might accord with Taleb's Black Swan thinking, that rather than pretend to predict risks that are fundamentally unpredictable, it is wiser to insure for inevitable disasters.)https://en.wikipedia.org/wiki/Fail-safe
In engineering, a fail-safe is a design feature or practice that in the event of a specific type of failure, inherently responds in a way that will cause no or minimal harm to other equipment, the environment or to people.
Unlike inherent safety to a particular hazard, a system being "fail-safe" does not mean that failure is impossible or improbable, but rather that the system's design prevents or mitigates unsafe consequences of the system's failure. That is, if and when a "fail-safe" system "fails," it is "safe" or at least no less safe than when it was operating correctly.Sociologically, Japan might be described as a classic case of a fail-safe system. In such a system, amidst calamity, things do not fall apart as they would in other societies because of remarkable social cohesion. Unfortunately, that kind of system is also not a dynamic, creative system that can re-invent itself. When the economy fails, no one starves, but there is seemingly endless stagnation.
The challenge is to create a system that is not only more robust and can better withstand impacts, but also more vital so that in the aftermath of a disaster, the system can reinvent itself. It could be that a bottom-up system is not only more capable of spontaneous regeneration, but it would remake itself into a new form.
Self-organizing systems
Perhaps a self-organizing system -- in which some form of overall order arises from local interactions between parts of an initially disordered system -- would be both fail-safe as well as more robust to begin with. A self-organizing system might even be more self-healing and recover quicker. For example, the internet is a collection of overlapping systems that continue to function together when any one of the systems fail. That is a fail-safe design, and it is also self-organizing.https://en.wikipedia.org/wiki/Self-organization
In terms of urban planning, self-organization would involve the transition to autonomous and net-zero energy buildings that not only engage in distributed production, but also exchange and coordination of resources between buildings. Moreover, localities and regions would also be required to have some degree of self-sufficiency in food, water and energy production and consumption, which would be coordinated at the local and regional level.
Indeed, in his book "Antifragile", Talib argues for built-in such insurance, pointing to the naturalistic model of organisms which always have a backup system -- organs come in pairs -- a strategy that most economists would scorn as inefficient.
Talib's notion of "antifragility" offers a whole new way of thinking about disaster preparation.
Antifragile
In Talib's understanding, there are policies that would make it possible to actually grow and benefit from disasters that are not overly severe. A society with the right policies might not only survive a plague, but profit by it. What does not kill you makes you stronger.For Talib, there are three kinds of entities:
- those that are fragile and break easily,
- those that are more robust and shockproof -- up to a point, and
- those that not only survive moderate shocks, but improve because of them.
https://www.fooledbyrandomness.com/prologue.pdf
I. HOW TO LOVE THE WIND
Wind extinguishes a candle and energizes fire.
Likewise with randomness, uncertainty, chaos: you want to use them, not hide from them. You want to be the fire and wish for the wind. This summarizes this author’s nonmeek attitude to randomness and uncer-tainty.
We just don’t want to just survive uncertainty, to just about make it. We want to survive uncertainty and, in addition— like a certain class of aggressive Roman Stoics— have the last word. The mission is how to domesticate, even dominate, even conquer, the unseen, the opaque, and the inexplicable.
How?
II. THE ANTIFRAGILE
Some things benefit from shocks; they thrive and grow when exposed to volatility, randomness, disorder, and stressors and love adventure, risk, and uncertainty. Yet, in spite of the ubiquity of the phenomenon, there is no word for the exact opposite of fragile. Let us call it antifragile.
Antifragility is beyond resilience or robustness. The resilient resists shocks and stays the same; the antifragile gets better. This property is behind everything that has changed with time: evolution, culture, ideas, revolutions, political systems, technological innovation, cultural and economic success, corporate survival, good recipes (say, chicken soup or steak tartare with a drop of cognac), the rise of cities, cultures, legal systems, equatorial forests, bacterial resistance . . . even our own existence as a species on this planet. And antifragility determines the boundary between what is living and organic (or complex), say, the human body, and what is inert, say, a physical object like the stapler on your desk.
The antifragile loves randomness and uncertainty, which also means — crucially — a love of errors, a certain class of errors. Antifragility has a singular property of allowing us to deal with the unknown, to do things without understanding them— and do them well.Talib suggests that the best strategy for making a system antifragile is to build uncertainty and hardship into the system itself. He suggests several ways to do this.
https://en.wikipedia.org/wiki/Antifragile
Skin in the game. Decision-makers should always have proverbial "skin in the game". That is, the leadership of a society or business should be personally vested in the survival of the enterprise that they lead, or they will game policies to make the system fragile and failure-prone. If the policy is not for the captain to go down with the ship, the ship is doomed. Profits will be privatized, and risks will be socialized.
To me, every opinion maker needs to have “skin in the game” in the event of harm caused by reliance on his information or opinion (not having such persons as, say, the people who helped cause the criminal Iraq invasion come out of it completely unscathed). Further, anyone producing a forecast or making an economic analysis needs to have something to lose from it, given that others rely on those forecasts (to repeat, forecasts induce risk taking; they are more toxic to us than any other form of human pollution).
Situation in which the manager of a business is not the true owner, so he follows a strategy that cosmetically seems to be sound, but in a hidden way benefits him and makes him antifragile at the expense (fragility) of the true owners or society. When he is right, he collects large benefits; when he is wrong, others pay the price.
Typically this problem leads to fragility, as it is easy to hide risks. It also affects politicians and academics. A major source of fragility.Via negativa. Another strategy to promote antifragility is, in a sense, to achieve health by subtracting medication. We must edit our lives because quality of life is based not on what we have, but on what we can eliminate. (Humphrey Bogart used to say that the only really good thing about having money is that it allows one to tell jerks to go screw themselves.)
I would add that, in my own experience, a considerable jump in my personal health has been achieved by removing offensive irritants: the morning newspapers (the mere mention of the names of the fragilista journalists Thomas Friedman or Paul Krugman can lead to explosive bouts of unrequited anger on my part), the boss, the daily commute, air-conditioning (though not heating), television, emails from documentary filmmakers, economic forecasts, news about the stock market, gym “strength training” machines, and many more.Lindy effect. One thing to eliminate is "neomania", or the craze for the new and fashionable.
A technology, or anything nonperishable, increases in life expectancy with every day of its life—unlike perishable items (such as humans, cats, dogs, and tomatoes). So a book that has been a hundred years in print is likely to stay in print another hundred years. The opposite is Neomania, a love of change for its own sake, a form of philistinism that does not comply with the Lindy effect and that understands fragility. Forecasts the future by adding, not subtracting.Barbell strategy. Extremely risky strategies are fragile, whereas safe policies are robust but stagnant. The antifragile strategy is to combine both of these paths simultaneously.
A dual strategy, a combination of two extremes, one safe and one speculative, deemed more robust than a “monomodal” strategy; often a necessary condition for antifragility. For instance, in biological systems, the equivalent of marrying an accountant and having an occasional fling with a rock star; for a writer, getting a stable sinecure and writing without the pressures of the market during spare time. Even trial and error are a form of barbell.How does the Talib's concept of antifragility apply to epidemics?
When applied to the Black Death of the 14th century, in biological terms, the plague tended to kill off those who more "frail" and rendered the descendants of those who had survived more immune to disease.
https://www.americanscientist.org/article/the-bright-side-of-the-black-death
Economically and politically, the labor shortage created by the plague lifted living standards for workers and destroyed a feudal system already in decline, and outsiders came under persecution. The favorable conditions for labor diminished as populations recovered, although the persecution persisted. Nevertheless, the Black Death was a classic unexpected transformative Black Swan event that rendered western Europe more antifragile.
https://en.wikipedia.org/wiki/Consequences_of_the_Black_Death
What will be the consequences of the Plague of 2100? Will it make the world more antifragile? What policies promoting antifragility would prepare humanity for the coming plagues?
