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Ready for an Epidemic?

In the latest City Journal, Peter Huber offers a must-read essay on our society’s acute and growing vulnerability to infectious disease. As he notes, it is a problem that many at the highest levels of government are downright obsessed with these days, and rightfully so.

In recent years, that obsession has been most evident in federal efforts to prepare for a potential epidemic of the “bird flu.” Avian influenza, we’ve been told, could be the next major global pandemic, on par with the deadly flu outbreak that killed tens of millions worldwide (including about 675,000 Americans) in 1918. Our government has devoted enormous energies and funds to the effort to prepare: undertaking exercises and “war-games,” producing a massive response plan, sending top officials to brief state and local leaders on what they would need to do in the event of an outbreak, and spending billions on the effort to stockpile both vaccines and treatments.

Among the key lessons of that process (a process in which I played a tiny part as a White House domestic-policy staffer) is one Huber does not address in his piece: the unprecedented vulnerability of our way of life to any disruption that causes large numbers of Americans to skip work. Staying home, especially if your job involves travel, is a logical reaction to an infectious disease outbreak, and public health officials are inclined to recommend doing so in the case of a serious epidemic.

But the miraculous American economy we have grown used to is made possible by a stunningly efficient “just-in-time” supply chain, in which raw materials and finished products are always on the move. Suppliers and sellers tend not to keep much in stock, since we can always rely on timely delivery of just what we need just when we need it. This makes for efficiency and productivity, but it also makes the whole system terribly vulnerable to disruption. If, say, a quarter of UPS’s workforce or of the country’s eighteen-wheeler drivers failed to come to work one day, the consequences would be swift and horrendous.

Think of it this way: unless you happen to live in the heart of the Midwest, it’s unlikely that much of your food came from anywhere near where you bought it. And wherever you live, only a small portion of the products in your supermarket were there a week ago, or will be there a week from now. That means that after a week without truck drivers, much of the country would be in genuine danger of running out of food and supplies, astounding as that may seem. And you can bet that a serious outbreak of infectious disease would keep drivers home—even those who were not actually sick would be scared of exposure.

This is why the kind of preparation the government undertook when a bird-flu outbreak seemed imminent was warranted. And even if the threat of avian influenza itself was exaggerated (which some commentators have plausibly argued), these preparations will serve us in the event of another serious infectious outbreak. As Huber notes, if history and epidemiology are any guides, it’s a not question of if but of when.


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