Unknown Unknowns – Some Future Health Crises (4/2/13)
The Known Unknowns
You don’t have to read Nicholas Nassim Taleb’s “The Black Swan” to recognize unpredictable events produce inordinate impact. Consider the major events of your own life – marriage, work, serious illnesses. How many of them were predictable? Chance rules the world.
Presently most “health” crises are, in policy terms, health care crises. Given the “Eight Americas” Study showed American populations varied almost 40 years in lifespan – with lifestyle the major variable – this puts the cart before the horse. Though thought of first, health care is often a rather late consideration when trying to prevent future health disasters.
So what are some of the “known unknowns”, factors that might upend the health of American and global populations? Here’s a small list.
1. Chemicals. Estimates are that 80,000 to 100,000 new chemicals have been unleashed into the environment in the last sixty five years. According to the Economist and US government sources, approximately 200 have become “well characterized.” Chemical induced cancer epidemics, feared from the 1960s on, fortunately have not occurred. Yet the effect of these chemicals on the environment, pathogens, the microbial life that supports life? Presently colony collapse disorder, destroying pollinating bees around the world, is hypothesized to result from neonicotinoids and increased herbicide use with genetically modified crops. But the overall effect of tens of thousands of new chemicals on health? That’s unknown.
2. Drugs. Prozac, arsenic, and estrogens just don’t show up in the chickens you eat for dinner. They’re all over the water supply. Swedish research, putting such water in the tank with local fish, has shown some rather Frankenstein type results. What is the effect of hundreds of trace drugs in the human water supply and food chain? Unknown. And as Taleb likes to point out, absence of evidence is not evidence of absence.
3. Pollutants. Slowly it has dawned on policy makers that industrial pollutants, like mercury and particulates, are major causes of pulmonary disease and cancer. But what do they do to overall immunity? And to hundreds of thousands of different bacteria, fungi, prions, viruses, rickettsia and mycoplasma that can infect and kill us? Unknown.
4. Genetically modified crops and animals. Humans have been tinkering with other species’ genes for thousands of years. But what happens when genetically modified crops take up the majority of a nation’s foodstuffs, and a new pathogen comes that suddenly mows them down? That’s unknown.
5. Bioweapons. Recent work in the US and the Netherlands showed how easy it would be to modify a bird flu virus with genes from other influenzas to create a new human pathogen. In the past, Russian defector Ken Alibeck argued the Soviets created a respiratory forms of pathogens like anthrax and even smallpox that were 95% lethal to animals. What might the Iranians, the North Koreans, or different terrorists groups with tens of millions of dollars and a group of dedicated scientists create? That’s unknown.
6. Climate Change. The Earth has gone through rapid climate change before. But some estimates are we have heated the planet more in the last century than we have cooled in the past 6000 years. Changes in the next century will be far more impressive. What effect will that have on human diseases and pathogens? That’s unknown.
Fears and Realism
Fortunately for us human evolution has equipped with bodies whose information systems are formidable and whose overall capabilities are merely guessed at. The pandemics and epidemics that have not occurred probably vastly outnumber the ones we know about, like AIDS and the influenza epidemic of 1918-19. There’s a lot under our hoods that has saved us time and again. The human immune system is capable of creating billions of new chemicals to fight infection within days, using it’s own “patented” version of forced evolution. And there are seven billion of us on the planet, all with different operating systems and equipment.
No doubt these hidden and generally extraordinary capabilities – which most of us take for granted – may save us again and again. Human regenerative capacity is amazing, no matter how little of it we understand.
But we must also recognize our need to prepare for things we can’t see or predict. The imaginable horrors noted above are just known unknowns.
It’s the unknown unknowns we really need to worry about.
Chance rules the world. Chance favors the prepared mind.
We have a lot of thinking to do if we are to prevent health crises in the future – and a lot of working improving our health and environment meanwhile.
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