Megacities and the Pandemic of Doom

ON OCTOBER 2nd a British traveller, flying home to Glasgow from Afghanistan, began to feel ill. Within hours he was diagnosed with Crimean-Congo Haemorrhagic Fever, a virus nasty enough for him to be put onto a military transport aircraft for transfer to an isolation hospital in London. Less than 24 hours later he was dead.

This outbreak, on top of another death last month in Saudi Arabia from a previously unknown virus, a cousin of the Severe Acute Respiratory Syndrome (SARS), has set global health agencies on edge... _Economist

Metropolis of Tomorrow

Fast global travel brings the people of the world -- and their emerging infectious diseases -- closer together than ever before. Pandemics and plagues are spread by travelers, over distances both long and short. The human consequences of a widespread pandemic involving an emerging and deadly contagion, can be severe:

In the 1500s and 1600s, European epidemics killed perhaps 90% of the aboriginal Americans. In the 1400s, the plague killed one third of the humans in Europe. The worldwide influenza of 1918 killed 30 million, and AIDS had killed at least half that by 2000... newly-arising pathogens rarely seem to extinct their host species even in their initial outbreak. Genetically-engineered pathogens may be different. _Future Global Catastrophes

A pathogen would have to be designed to spread easily from person to person, persist in the environment, resist antibiotics and immune responses, and cause almost 100% mortality. Designing for long latency (e.g. months) might be necessary to ensure wide distribution, but no length may be enough to infect every last human. _Bioterrorism

There are barriers to the spread of epidemics. Airports, seaports, and train stations can be shut down for the duration of an epidemic. Infected travelers can be rapidly diagnosed and whisked into quarantine.

But in the emerging age of megacities, how would you stop an epidemic that has already established a strong foothold inside a city of 50 million people?

Infected persons would seek medical help soon after the outset of symptoms. If the early symptoms are not too severe, cases may be medicated and sent home -- but not before passing the infection on to health care workers and others they may have come in contact with in waiting rooms and in transit.

The contagion would rapidly spread through schools and workplaces across the megalopolis, perhaps infecting millions before the extent of the problem becomes apparent. By then, any modern methods of quarantine would not likely be effective at stopping the pandemic.

There are now 23 megacities in the world, compared with just two 60 years ago. Just over half of the population currently dwells in cities, and with the urban population expected to nearly double by 2050, that proportion is projected to approach 70%. “Almost all this growth will take place in the developing world,” says Jalkanen. _Nature

There is nothing new about large scale devastation and collapse from epidemics and pandemics. But the rise of megacities provides emerging infectious diseases -- to say nothing of engineered pathogens -- with an opportunity for devastation that may be too good to pass up.

Human history has been punctuated frequently by epidemics, and occasionally by pandemics, that have shaped the rise and fall of civilizations and the victories and defeats of warring armies. The outcome of the Peloponnesian War (431–404 B.C.E.) between Athens and Sparta—and the future course of Western civilization—might have been very different had it not been for the epidemic that decimated the Athenians at the beginning of the war. Some epidemic diseases, such as the plague, smallpox, typhus, and influenza, have persisted throughout recorded history. Smallpox was eradicated worldwide by 1980. Cholera appeared along the world's major trade routes in several devastating epidemics beginning in the eighteenth century, and it still causes massive epidemics, most recently in South America in early 1990s. _Timelines of Great Epidemics

If the contagion is sufficiently disabling, megacities will lose their health care systems fairly early on. Soon thereafter, parts of the critical infrastructure will begin to drop off line, one by one, as key personnel are put out of action -- or attempt to flee the pandemic.

Public supplies of necessities will be rapidly depleted -- first lawfully, then by mass looting. Organised law enforcement and fire departments will be among the first to go down, leaving most of the megacity to the mobs. Collapse of any remaining services should follow soon after.

There are inevitable problems when one tries to put all his eggs in one basket. Large systems are prone to chaotic instabilities that tend to grow along with the size of the system. It is possible to design redundancies, workarounds, and other attempts at resiliency. But in the third world and emerging world -- where most megacities are appearing -- few resources will be devoted to resiliency when poverty is already rampant, and open sewers are the norm rather than the exception.

The tendency toward centralisation and hyper-urbanisation appears to be inevitable across most of the world. Yet there are many vulnerabilities to such concentrations of people, resources, and infrastructure. Many people have no choice, if they wish to enjoy some of the many benefits and opportunities of civilisation.

But dangerous children know how to bring civilisation along with them, wherever they go. It is never too late to have a dangerous childhood.

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