Most people have seen the scary math on how unprepared humanity is for #COVID2019, particularly US medical infrastructure (e.g. masks, hospital beds, HT @LizSpecht). But I don’t think most people realize that this crisis, and S&P 500 drop, was entirely foreseeable. A thread. 1/11

The first layer of the onion is that we knew a global pandemic was coming. For just one example, in a 2015 discussion with @EzraKlein, @BillGates said a deadly flu-like pandemic is the most predictable disaster in the history of the human race ( https://www.vox.com/2015/5/27/8660249/bill-gates-spanish-flu-pandemic). 2/11

This perfect storm has been obvious for years: wild animal trade and factory farms to transfer diseases to humans—often with antibiotic resistance, dense urbanization and low sanitation to incubate an outbreak, mass travel to spread it, and a lack of government preparation. 3/11

The second layer is that the international community could have easily began #COVID19-specific preparation in January. The first reported symptoms were on Dec 1, and observers had a general sense of its trajectory within 1-2 months of that (e.g. ~7 day doubling, R >> 1). 4/11

In particular, there was lag with Wuhan Municipal Health Commission, which also downplayed the outbreak when it was finally publicized, and with the intl health community as more and more info came out Dec 31–Jan 24 (e.g. this paper in @TheLancet: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30183-5/fulltext). 5/11

There are strong incentives that drive all sorts of institutions to lag. This isn't a context where efficient markets thrive. If authorities act as soon as there is evidence for, say, a 30% chance of outbreak, they face big repercussions when nothing happens 70% of the time. 6/11

Of course authorities won't drag their feet until the issue is obviously severe, but that's too late in the context of pandemics. We need to act even when severity is not assured, and that's just not something that can happen in the current socio-political system. 7/11

The final layer of this deadly onion is the public and the shortsighted news cycle. I know many people who still haven't done any sort of preparation. I see many men still not washing their hands in public restrooms, even when others are already quarantined here in New York. 8/11

People struggle immensely with the nature of exponential growth. Coronavirus might not peak in the US until May or later. We will get bored. We won't take the desperate measures that might be needed, e.g. mass production/distribution of ventilators and oxygen concentrators. 9/11

Worse, after this pandemic ends, there probably won't be sustained public and activist pressure to reform this broken socio-political system. We don't need to live in constant fear, but we need a general shift in resources away from tomorrow and towards the distant future. 10/11

#COVID19 is not the last and certainly not the worst crisis we face in the 21st century. This is why I'm grateful for groups like the Future of Humanity Institute and Center on Long-Term Risk. We need a long-term, global outlook to take on the existential risks we now face. 11/11