Venkatesh Rao

Maybe, like fossil fuels, freedom from infectious disease was a temporary win. Maybe we’re at the beginning of a secular depopulation environmental force: infectious diseases 2.0.

If so, cities are done, both first-world aging population and third world overpopulation are solved in macabre ways, labor gets really pricey, healthcare gets radically reimagined around decentralized palliation etc. The worst case is easier to analyze than intermediate.

This isn’t primarily a medical or biological factors future. Even if we figure out a steady state treatment and management and vaccination regime, the economic and state capacity to run the playbook may not exist within current governance models.

For like 70 years our world’s political-economic structure has assumed state+market capacity to manage disease. Countries were admitted to “developed” status green zone primarily on the strength of demonstrating that capacity.

We’re now in the bizarre condition of the world’s supposedly most developed nation (still true in a dozen important ways) having failed the hardest at this basic state competence test. And for cultural reasons, not technological.

Cultural as in: broken public+private basic healthcare system, abandonment of the most vulnerable, and a third of the country joining a Trumpist death cult where patriotic courage is defined as giving others disease. Having the best univs and hospitals can’t fight that.

Grim thing is: flu watchers expect ~5 dangerous flu pandemics in the next century. This one’s kinda a bonus. Then there’s antibiotic resistance and stuff. A whole empire of other diseases held at bay at gradually increasing cost.

Need high density for climate change, low density for disease resistance. High globalization for economic growth and standard of living, loa globalization for climate and disease management. Running into some pretty tough trade offs here.