Scenario Z: Covid is never brought under control, mutates too much every season to be managed like the flu, and goes endemic with higher base fatality rate and is too costly to chase with vaccines. Joins the top-3 ranks of steady modern killers alongside heart disease and cancer.

This would be truly unprecedented. Infectious disease hasn’t dominated human affairs for decades. It differs from longevity driven modernity diseases in being more random and less governable.

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.

We’ve lost 2-3 macro degrees of systemic freedom in the last 6 years and not gained on other fronts. Depopulation is the natural way the imbalance might correct itself. That means continuing on current course of world being increasingly ungoverned and ungovernable for decades.

After Black Death, ungovernable state and depopulation lasted almost 200y. It is not a given that the world is necessarily governable simply because we prefer it. Governance escape is possible just as immune escape is.

Right now I’d assess Scenario Z at <10%. But last year when this started it wasn’t even in my scenario set.

Scenario Z isn’t post-Covid. It’s the scenario where we never actually get to post-Covid. Just declare victory and give up, shrinking governance to a feasible set.

I hope all the people arguing coronaviruses mutate less etc are right. But sadly the risk of Scenario Z is broader — limits of politics and economics in a world that is vastly more high-tech than the minds of its median inhabitants, facing a microbial environment ratchet.

Don’t forget, human civilization has spent 6000 years in a infectious-disease-ravaged state and only 60 in an infectious-disease-dominating state. 1% of history. No fundamental reason to believe the state change is an irreversible level-up with backsliding being impossible.

Again, not being alarmist. This is still a <10% scenario for me. But I’m concerned people who know better aren’t openly worrying enough about the new mutations, taking news from Manaus seriously, etc. This thing is close to escaping control just as we’re congratulating ourselves.

In a way, Trumpist death cult has already bought into Scenario Z. They seem to have decided this is a desirable cull of weakness out of the species along the way to their restoration of a glorious pre-modern condition of Real Men™ wielding guns, germs and steel for glory of god.

Several people are pointing out that the correlation between density and disease management is not straightforward. Taiwan and SF have had good records, while LA and NY failed. My take is that density in a disease-risk world demands *good* urban governance which you cannot assume

ps Don't go around quoting my <10% guesstimate as based on anything at all. I have zero idea how to actually estimate probabilities here. Too many variables in the mix. It's kinda like Drake's equation in the great filter. P(governance escape) = f(clusterfuck)