Tag: smallpox

From Watts Up With That?

Roger Caiazza

An article about response plans for pandemics by Joe Nocera writing at the Free Press described the plans by the scientist credited for eradicating smallpox for combatting an epidemic.  I was struck by the parallels between the differences between his recommendations and the lockdown plan response to Covid and the plans to transition the electric system to net-zero greenhouse gas emissions.

D. A. Henderson

The Free Press has a weekly series of articles, The Prophets, about “fascinating people from the past who predicted our current moment and make our world more understandable today.”  Joe Nocera’s article “spotlights D.A. Henderson, the epidemiologist who warned that pandemic lockdowns won’t stop a disease but could instead lead to a public health disaster.”  It is a very interesting article and I recommend it highly.  He writes:

In 2006, ten years before his death at the age of 87, the legendary epidemiologist D.A. Henderson laid out a plan for how public health officials should respond to a major influenza pandemic. It was published in a small journal that focused mainly on bioterrorism—and was quickly forgotten.

As it turns out, that paper, titled “Disease Mitigation Measures in the Control of Pandemic Influenza,” was Henderson’s prescient bequest to the future. If we had followed his advice, our country—indeed, our world—could have avoided its disastrous response to Covid.

Nocera describes Henderson’s background.  After graduation from medical school, he took a job at the U.S. Communicable Disease Center—the original name for the Centers for Disease Control and Prevention, or CDC.  In 1960 as the head of the CDC’s new disease surveillance department smallpox was “high on his list of concerns—and for good reason. Ancient, airborne, and highly contagious, smallpox was estimated to have caused around 300 million deaths in the twentieth century alone.”  At that time smallpox was under control in the United States but he was worried about the possibility that an infected person could come and start an outbreak.  “When the World Health Organization announced a program aimed at eradicating smallpox, Henderson’s superiors at the CDC transferred him to the WHO in 1966 to take charge of what many scientists believed was a futile mission.”

There was an effective vaccine for smallpox but many thought that it wasn’t possible to vaccinate enough people to eradicate the disease.  Henderson’s plan was to place doctors and volunteers in all the places where the disease was still rampant and respond to breakouts as quickly as possible.  Quarantines and better vaccination technology enabled people to rapidly vaccinate everyone associated with a local breakout of the disease.  Henderson was the driving force to implement the plan across the world.  Nocera states:

In 1980, after two years without a single recorded case of smallpox, the World Health Organization declared it eradicated. Science writer Richard Preston, who wrote the introduction to Henderson’s book on the effort, described this feat as “arguably the greatest lifesaving achievement in the history of medicine.”

Pandemic Response

During G. W. Bush’s Administration, a program to develop a plan for a pandemic was put in place:

This was prompted by the book he brought on vacation in 2005, The Great Influenza, a terrifying account of the 1918 flu pandemic estimated to have killed 50 million people worldwide. Bush had already been caught flat-footed on 9/11. He did not want the government to be unprepared in the case of a killer virus. So he ordered that a plan be devised for responding to such a deadly microbe. “Look,” the president said, “this happens every hundred years. We need a national strategy.”

Nocera explains the response developed:

When a team of government scientists completed the plan two years later, among its central tenets was that schools and other institutions should be closed, and that there should be “reduced contact among adults in the community and the workplace.” This meant lockdowns. This was exactly the opposite of the wisdom about pandemics Henderson had acquired during his long career. He tried to tell them that, but his words fell on deaf ears.

The lockdown plan was based on a computer model advocated by Robert Glass, a senior scientist at Sandia National Laboratories in New Mexico:

Robert Glass found that when he entered different variables on how to stop a respiratory virus from spreading, the most effective way was to close schools—along with other parts of society as necessary. Glass managed to get this model to the two government scientists leading the team developing Bush’s pandemic plan, Dr. Carter Mecher and Dr. Richard Hatchett, who quickly embraced it.

Though none of them were epidemiologists, Mecher, Hatchett, and Glass were convinced that computer modeling would transform epidemiology. In The Premonition, Glass reflected on old-school scientists like Henderson with a kind of pity. “I asked myself, ‘Why didn’t these epidemiologists figure it out?’ ” he told Lewis. “They didn’t figure it out because they didn’t have the tools.” Tools like computer models.

At this point I was struck by the similarity between these modelers and the academic energy system modelers.  In particular, the arrogance that their models are the be all and end all tool to address the problem at hand and the condescension towards experts in the field.    

Nocera notes that Henderson tried to respond:

Henderson, on the other hand, believed that basing pandemic mitigation strategies on hypothetical models—models that themselves were based on hypothetical assumptions—could lead policymakers deeply astray. He said that people behaved in unpredictable ways that models could not capture.

Before the plan was finalized Henderson and other epidemiologists met with the modeling team.  The meeting did not go well with the epidemiologists all “berating the Bush team for failing to back up their draconian shutdown proposals with real-world evidence”.

But Mecher and Hatchett stuck by their model, and that was reflected in the pandemic plan, which was published in 2007. Henderson never stopped believing that the path the Bush administration chose was potentially disastrous.

The paper Henderson and his three younger colleagues wrote in 2006, after Henderson’s meeting with Bush’s team, was their last-ditch effort to stop the lockdown plans of the modelers. In retrospect, it was more than a mere journal article. It was a warning about what public health should and shouldn’t do during an outbreak of a highly contagious respiratory illness. It was also a manifesto about the purposes, and limits, of public health.

As he and his co-authors wrote in the 2006 paper:

What computer models cannot incorporate is the effects that various mitigation strategies might have on the behavior of the population and the consequent course of the epidemic. There is simply too little experience to predict how a 21st century population would respond, for example, to the closure of all schools for periods of many weeks to months.

We now know exactly how school closures affected the nation. The answer is very badly.

Nocera describes the negative consequences.  For example, the performance of students during the lockdown was disastrous and will have long-term effects.  If the lockdown had been effective at stopping the spread of the virus there would at least be a mitigating factor.  Nocera quotes Michael Osterholm, the prominent University of Minnesota epidemiologist, , “Look at what happened in China. They locked down for years, and when they finally relaxed that effort, they had a million deaths in two weeks.”

Parallels to the Net-Zero Energy System Transition

D. A. Henderson was a hands-on epidemiologist.  His mentor taught him the value of “shoe-leather epidemiology” which is shorthand “for the activities of an epidemiologist who left his office to personally investigate epidemics—collecting data and interviewing patients and officials”.  He also demonstrated hands on leadership in the fight to eradicate smallpox.  My point his position was developed based on personal experience.

My primary concern is the New York Climate Leadership & Community Protection Act net-zero transition.  As part of that transition the Climate Action Council (CAC) is responsible for preparing the Scoping Plan that outlines how to “achieve the State’s bold clean energy and climate agenda.”  There also are two modeling approaches for the transition plan.  The entities responsible for electric system reliability rely on bottom-up models based on decades of experience with the all the components of the electric system.  On the other hand, the basis of the Scoping Plan is modeling by academics that is a top-down approach.  I am convinced that the top-down modeling to date overlooks too many critical aspects of the electric system to be credible.  That the state has not reconciled the differences between the New York Independent System Operator electric system projections and the analyses performed by the New York State Energy Research & Development Authority is a prescription for the same disastrous outcome as the pandemic response.

Conclusion

I have enough modeling experience to opine on their use.  Observations always trump model projections.  The reliance on models like the Global Climate Models that can never be properly verified by comparison to observations must always keep that in mind.  The net-zero transition energy modeling is in two camps.  The academic top-down approach can be verified but the results are unimpressive.  Even the bottom-up models used by the entities responsible for electric system reliability have issues but there is a constant improvement based on refinements to address observations.

This article clearly shows that the Covid response should have relied on the epidemiologists whose observations suggested a different approach more akin to what Sweden did.  “Sweden’s death rate wound up being one of the lowest in the world—4 percent during 2020 and 2021. The U.S. excess death rate in the same period was 19 percent.”  I fear that ignoring the responsible energy experts and relying on theoretical energy system modeling will have similarly disastrous impacts. 

Finally, note that it is clear that the United States plan for the next pandemic has to be changed.  I can only hope that the advice of D. A. Henderson will be heeded this time.

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Roger Caiazza blogs on New York energy and environmental issues at Pragmatic Environmentalist of New York.  More details on the Climate Leadership & Community Protection Act are available here and an inventory of over 370 articles about the Climate Act is also available.   This represents his opinion and not the opinion of any of his previous employers or any other company with which he has been associated.