The J Curve

Wednesday, June 28, 2006

Brainstorm Questions

The editors of FORTUNE magazine asked four questions of the attendees of Brainstorm 2006. Ross Mayfield is blogging the replies and the ongoing conference. Here are my answers to two of the questions:

• WHAT THREE GLOBAL LEADERS WILL HAVE THE GREATEST IMPACT IN SETTING THE COURSE FOR THE NEXT DECADE?

None of the individuals named today.

I would bet that in 2016, when we look back on who has had the greatest impact in the prior 10 years, it will be an entrepreneur, someone new, someone unknown to us at this time.

Looking forward from the present, we tend to amplify the leaders of the past. But in retrospect, it’s always clear that the future belongs to a new generation. A new generation of leaders will transcend political systems that cater to the past. I would bet more on a process of empowerment than any particular person.

• WHAT DO YOU FEAR MOST?

I tend to be out of touch with fear as an emotion, and so I find myself rationally processing the question and thinking of the worst near-term catastrophe that could affect all of us.

At perhaps no time in recorded history has humanity been as vulnerable to viruses and biological pathogens as we are today. We are entering the golden age of natural viruses, and genetically modified and engineered pathogens dramatically compound the near term threat.

Bill Joy summarizes that “The risk of our extinction as we pass through this time of danger has been estimated to be anywhere from 30% to 50%.”

Why are we so vulnerable now?

The delicate "virus-host balance" observed in nature (whereby viruses tend not to be overly lethal to their hosts) is a byproduct of biological co-evolution on a geographically segregated planet. And now, both of those limitations have changed. Organisms can be re-engineered in ways that biological evolution would not have explored, or allowed to spread widely, and modern transportation undermines natural quarantine formation.

One example: According to Preston in The Demon in the Freezer, a single person in a typical university bio-lab can splice the IL-4 gene from the host into the corresponding pox virus. The techniques and effects are public information. The gene is available mail order.

The IL-4 splice into mousepox made the virus 100% lethal to its host, and 60% lethal to mice who had been vaccinated (more than 2 weeks prior). Even with a vaccine, the IL-4 mousepox is twice as lethal as natural smallpox (which killed ~30% of unvaccinated people).


The last wave of “natural” human smallpox killed over one billion people. Even if we vaccinated everyone, the next wave could be twice as lethal. And, of course, we won’t have time to vaccinate everyone nor can we contain outbreaks with vaccinations. 


Imagine the human dynamic and policy implications if we have a purposeful IL-4 outbreak before we are better prepared…. Here is a series of implications that I fear:

1) Ring vaccinations and mass vaccinations would not work, so
2) Health care workers cannot come near these people, so

3) Victims could not be relocated (with current people and infrastructure) without spreading the virus to the people involved.

4) Quarantine would be essential, but it would be in-situ. Wherever there is an outbreak, there would need to be a hair-trigger quarantine.

5) Unlike prior quarantines, where people could hope for the best, and most would survive, this is very different: everyone in the quarantine area dies.

6) Where do you draw the boundary? Neighborhood? The entire city? With 100% lethality, the risk-reward ratio on conservatism shifts.

7) How do you enforce the quarantine? Everyone who thinks they are not yet infected will try to escape with all of the fear and cunning of someone facing certain death if they stay. It would require an armed military response with immediate deployment capabilities.

8) The ratio of those available to enforce quarantine to those contained makes this seem completely infeasible. With unplanned quarantine locations, there is no physical infrastructure to assist in the containment.

9) Once word about a lost city spreads, how long would it take for ad-hoc or planned “accelerated quarantine” to emerge?
10) Once rumor of the quarantine policy spreads, doctors would have a strong perverse incentive to not report cases until they made it out of town…