
The Terrifying Lessons of a Pandemic Simulation - scentoni
https://www.newyorker.com/science/elements/the-terrifying-lessons-of-a-pandemic-simulation
======
reaperducer
There is an interesting amount on behind-the-scenes IT going on for just this
sort of disaster, and others, in the government sector.

We don't hear about any of it, so we assume nothing is being done. But the
reason it's kept secret is so that people don't start freaking out at scary
tabloid headlines.

For example, there is a thing called "the black web" (different sectors have
different names for it). Many U.S. government agencies have websites ready to
launch in the event of a catastrophic calamity like a pandemic or a radiation
leak that affects millions.

Source: Two people I worked with who worked on one of the projects.

~~~
briffle
its a good practice. This week, our town had a algae based toxin problem with
their water. They sent out emergency alerts via text, email, the school
district callouts, etc. I got texts forwarded from 8 friends/family.

Everyone referred you to the city's home page. The site buckled under the
load, and was completely unresponsive for hours. If it was a more urgent
emergency, the lack of information could have led to people being harmed.

I was hoping they would switch to a less dynamic site for alert pages, perhaps
use a CDN or edge proxy like cloudflare, etc. But no, it appears demand just
died off, and they are still doing the same thing. They just put out info on
where you can go to national guard filling stations to fill up water bottles,
and their home made .net based website is back to taking 10 seconds to render
the home page.

~~~
mkirklions
We had a water problem and I didnt know about it until days later.

No local TV and not reading the paper + no facebook= living somewhere else?

I knew all about HN, but no clue that we couldnt use water.

~~~
tombrossman
This is where Twitter excels. It's the best way I have found to get local
breaking news. Don't bother following any media outlets either, it's
counterintuitive but their feeds are mostly marketing garbage with extra click
tracking/redirects and excessive dupes. Pick a few local journos whose
articles or reporting you like and follow them instead. Those, plus random
friends and other local people will give you all the news you need almost
instantly. I don't even turn the TV on when something big happens any more, I
just check Twitter.

~~~
ghaff
That assumes you live somewhere that has local journos to speak of. I only
live about 40 miles outside of a major US city. But there's no real local news
source. I'd only find out about an emergency because of a auto-call from the
local emergency services or because it was such big news that it was covered
in the Boston Globe.

------
quux
The opening paragraphs of this article really remind me of the film Contagion,
which IIRC tried to portray a pandemic hitting the current world as
realistically as possible.

[https://en.wikipedia.org/wiki/Contagion_(film)](https://en.wikipedia.org/wiki/Contagion_\(film\))

~~~
SuspiciousSwan
It's even more accurate than I thought when I saw it. I assumed the the
visualization of the virus was stupid movie crap, then I worked in
bioinformatics and realized it was [https://pymol.org/2](https://pymol.org/2)
. One of my friends worked for the state health department, and she said that
the level that R0 was explained was spot on as well.

~~~
Fomite
I'm an infectious disease epidemiologist - their explanation of R0 (which is
occasionally a silly concept but that's another story) is one of the better
ones, and the one I use in my classes.

------
marmottus
Reminds me of this game, Plague Inc [1], where you can simulate a plague that
starts silently until the symptoms become too strong and starts a race between
the deadly decease and the governments looking for a cure together and closing
borders to prevent it from spreading.

[1] [https://www.ndemiccreations.com/en/22-plague-
inc](https://www.ndemiccreations.com/en/22-plague-inc)

~~~
therapeutic
One of my most frustrating memories was Madagascar shutting their borders down
at the first sign of disease in any other country. The bane of my teenage
existence.

~~~
gowld
That was originally Pandemic 2, which Plague Inc cloned.

[http://knowyourmeme.com/memes/shut-down-
everyting](http://knowyourmeme.com/memes/shut-down-everyting)

------
coldcode
We were 1 homeless person away from Ebola in the US, the ambulance in Dallas
picked up a homeless guy along with the guy who had Ebola. The homeless guy
wandered away from the hospital. While Ebola isn't always transmitted by close
contact, if it had been I bet there would have been thousands of people within
a few days with it. How many doctors or hospitals even recognize Ebola when a
random person walks in the door?

~~~
matt4077
Ebola transmission is almost always from patient to a close caregiver. While
the latter often are family members in Western Africa, someone bleeding from
all orifices will get to an ER much faster in the US. Some transmissions from
the index case would certainly be possible, although even standard hospital
practice goes a long way towards inhibiting it.

I doubt a diagnosis would take more than a day, especially if the patient
recently traveled or the hospital is near a major hub. Medical professionals
are as obsessed with such diseases as we are.

Once the threat is known, I have no doubt that any decent medical system would
contain it within a few days at the most. Ebola isn't the Sci-Fi threat you
might think, requiring Biohazard suits etc. Basic precautions work well,
finding possible contacts will be much easier, and the tendency of Americans
not to attend mass events helps tremendously: Cars instead of public
transport, Netflix instead of crowded bars, small families in suburban houses
instead of large families in shared apartments, Wall-Mart instead of markets,
etc

~~~
ff317
All somewhat true, but there are a few key areas where America does attend
mass events that can help spread diseases quickly. The top three examples in
my mind are the trifecta of public schools, large office complexes, and
churches (esp mega-churches).

These all feed and overlap each other. Something can spread through the public
school system's children quickly into parents, who take it into large shared
office building environments (think typical complex of skyscrapers full of
tenant companies sharing hallways, elevators, sidewalks, lunch spots, etc),
and once a week completely different insersectional sets of these adults and
children then gather up in a large church and disperse into the trifecta.

Hospitals themselves are another factor. Those with family ties end up
randomly visiting hospitals a few times a year on average for their eldery
relatives' or childrens' sakes, where they pick up a ton of chances at
diseases.

~~~
maxerickson
During a serious outbreak of something more transmissible than endemic disease
like the flu (and all the various viruses that give us colds), people would
freak out and attendance to all those things would plummet.

------
gringoDan
From this article, it seems like the simulation was acted out by people who
were _formerly_ in leadership/advisory positions in the US government.

How likely is it that current leaders heed their advice when an outbreak
happens? Wouldn't it be more useful to have the people currently in power
preparing for this?

Honestly asking - I have no idea about the modus operandi of Washington
bureaucracy.

~~~
philwelch
People who currently have these jobs are generally too busy to spend all day
wargaming through a simulated pandemic. You’d be lucky to sit them down long
enough to play the board game Pandemic. What probably ends up happening is
that this gets turned into a written report that some staffer has on hand to
pull out and brief the key decision makers on. As the article points out, the
learnings from these exercises sometimes get turned into actionable policy,
e.g. Bush implementing continuity-of-government plans.

The most similar thing I know about personally is military contingency plans.
My dad was a Marine Corps officer and, among other things, worked on
contingency plans in the late 1960’s. There are standing contingency plans for
almost every conceivable military operation the US might perform, ranging from
amphibious landings on the fjords of Norway to capturing any given small
Caribbean island. The plans don’t always get followed, though. My dad spent a
lot of time developing a contingency plan to capture the island of Grenada,
and he spent the rest of his life bitterly insisting that his plan was far
better than how that operation actually turned out!

~~~
cozos
That's actually really cool. What was his plan like compared to the actual
operation? Also, what kind of methodologies would one use to plan something
like this?

~~~
philwelch
He passed away some years ago so I'm just going off my recollections here.

His main complaint was that the actual operation used an unnecessarily large
cross-service force (largely for political reasons; the Air Force and Army
didn't want to miss out on the chance to get involved) when his plan required
less than a division of Marines with accompanying air support.

The contingency plans themselves are highly classified, and none of the plans
nor the associated maps and whatnot are allowed to leave a specifically
secured facility, making this one of the few times in his military career that
my dad couldn't just take home his paperwork at the end of the day. In the
case of the Grenada plan, there was already an existing plan that is
reevaluated and updated with new intelligence, doctrine, etc. on a periodic
basis.

One detail of the plan my dad mentioned investigating was a standing tank
(i.e. a large barrel for storing liquids) in the middle of a field on the
island. The old plan entailed securing the tank and using it as temporary fuel
storage, but my dad was suspicious. It turns out the tank was in the middle of
a sugar cane field. It was a molasses tank. Probably not safe or feasible for
fuel storage.

Even writing this out, I find this story a _little_ hard to believe, but
that's the level of detail the military, at least, puts into their contingency
plans.

------
ogennadi
> Even within the artificial confines of the simulation, there was a lack of
> leadership. Everyone agreed that the President had the final word on
> everything in general, but nobody seemed to be responsible for America’s
> outbreak response specifically. The table returned endlessly to questions
> about who would brief Congress; who would be capable of authorizing an
> emergency deployment of military tents as civilian isolation units; who
> would call state governors to try to ensure a coördinated national response;
> and who, even, would attend all the funerals.

------
mberger
>Some of the day’s dilemmas revealed vulnerabilities that are hardwired into
the American system. Some private hospitals, for instance, turned away Clade X
patients in order to protect their shareholders. (By the end of the
simulation, American health care had been forcibly nationalized.)

GL HF with that. What really would have happened is that the government does
what it always does: throw money at the problem. Every hospital gets x dollars
to prepare or gets x dollars per confirmed diagnosis. Change like that never
happens during a crisis, always after.

~~~
mullen
History does not back up that statement. During the Civil War, WWI and WWII
certain parts of the economy were nationalized. It would be safe to expect
that in a sever pan-epidemic that the health care system would be
nationalized.

~~~
mberger
I was thinking of the 2008 financial crises. Rather than nationalize banks
there was a bailout. In 911 there was no nationalization of airports or
airlines just more money to set up security theatre. I suppose it could be
argued that the DHS personnel are a nationalized rent a cop operation but that
sems like its something new not something appropriated

~~~
mullen
Airport security was nationalized after 9/11.

During the 2008 financial crises, the government did not nationalize the banks
but it did "nationalize" how some of the banks did fail. Banks that
could/would survive, were told to absorb banks that could not/would not
survive with money that the government provided and dictated how much it would
be paid back. Technically, not nationalization but pretty close.

------
EdwardCoffin
This sort of reminds me a of a story Danny Hillis has told about Shell Oil and
how they were the only major oil company that handled the 1980s oil glut [1]
at all well, because the executives had played through a simulation of it. He
talked about this in the 2000 game developer's conference keynote [2] (from
about 12:30 - 15:26). I've transcribed that bit below:

 _I think sensible business people are also playful business people. And I
think that any great development project, or any great engineering project,
you can feel it, you can walk into the room and see people playing around, and
you can see if they 're acting seriously.

There was actually an interesting case, I don't think they would think of this
as a game, but it was literally a game development story: Shell Oil.

Shell Oil -- in the 1980's, there was a time when the price of oil took a big
dive, now Shell Oil it turns out was the only company that handled that
situation well, and here's why:

Before then, oil was going up, up, up, and in order to be a good oil company
you basically had to drill wells as fast as possible, increase production
capacity as fast as possible, and pretty much all the oil companies were doing
that. The strategic planners at Shell Oil realized that the price of oil might
start going down, and that was bad news that no one in the oil industry wanted
to do, nobody really wanted to believe it. So they thought about how to get
these Shell Oil executives to actually pay attention to it, and they realized
the only way they would actually pay attention to this idea was in the context
of play.

So what they did is they basically built a simulation game of the oil
industry, and they had the Shell Oil executives sit there in the game and put
in their assumptions and play it out sort of like SimCity or something like
that, of what oil prices would do, according to their assumptions. So they all
played little roles, like one of them was an oil sheik, and another one was
OPEC, another their competitive refineries, things like that, and they played
out the consequences of various games. And one of the things that happened is
in every one of their scenarios, the price of oil would crash. And everyone
started laughing and they thought this was really silly, because of course
everybody knew this wouldn't happen. But after they played this game a while,
they started realizing that there were patterns that would happen. They were
able to learn in the safety of a game what they really couldn't ever think in
the danger of a real spreadsheet they were running the business with.

And in fact, that's what play lets people do. It lets them learn in safe
situations things that are actually going to be useful in life. And in fact,
in that particular example, Shell Oil realized from their playing that it was
actually plausible that the price of oil would collapse, they took some steps
to scale back some of their refineries and things like that, and they were the
only major oil company that was actually in good shape when that happened._

[1]
[https://en.wikipedia.org/wiki/1980s_oil_glut](https://en.wikipedia.org/wiki/1980s_oil_glut)

[2] [http://www.gdcvault.com/play/1014862/2000-GDC-Keynote-Dr-
Dan...](http://www.gdcvault.com/play/1014862/2000-GDC-Keynote-Dr-Daniel)
(requires Flash. The whole talk is pretty good, and immediately preceding this
bit is are funny anecdotes about Richard Feynman and Marvin Minsky)

------
sigsergv
The best pandemic simulation was Corrputed Blood Incident[1].

[1]
[https://en.wikipedia.org/wiki/Corrupted_Blood_incident](https://en.wikipedia.org/wiki/Corrupted_Blood_incident)

------
ourmandave
How did it end? Did they run out of cubes, player cards, or have 8 outbreaks?

------
jrjarrett
Those wily blue cubes, getting out of control.... usually, it's the black
disease cubes that outbreak.

[https://en.wikipedia.org/wiki/Pandemic_(board_game)](https://en.wikipedia.org/wiki/Pandemic_\(board_game\))

------
omegaworks
>Rear Admiral Tim Ziemer, had been removed from his position as the head of
global health security on the White House’s National Security Council after
the Trump Administration cut funds for fighting pandemics.

The present administration isn't interested in preserving the status quo in
the event of a pandemic. They are interested in preserving the whiteness of
America. An epidemic that they can shape the response and resources around to
cull the immigrant, native and slave-descended population would serve their
supremacist vision.

4,600 are dead in Puerto Rico due to their negligence. [1]

4,600 is a __conservative __estimate.

1\.
[https://www.nejm.org/doi/full/10.1056/NEJMsa1803972](https://www.nejm.org/doi/full/10.1056/NEJMsa1803972)

~~~
gwern
[http://andrewgelman.com/2018/06/01/data-code-study-puerto-
ri...](http://andrewgelman.com/2018/06/01/data-code-study-puerto-rico-deaths/)

------
Bromskloss
What was the lesson?

