Unlikely disasters

Abstract

If the threat of disaster—an earthquake, a pandemic, or a nuclear accident—is unlikely or uncertain in time, place, and scale, then prevention may not be seen as better than cure. A potential health emergency becomes more manageable when the cost is commensurate with the hazard and the risk. Tactics to satisfy that criterion are familiar to the insurance industry: spotlight preventable hazards, pool the risks, and share the costs. A hazard—such as COVID-19, Ebola or Zika virus—is perceived to be more dangerous, and more likely to stimulate action, when classified as a public health emergency or a threat to national security. Among the methods for pooling risks and sharing costs are early detection and response systems for multiple pathogens; platform technologies for the development of new diagnostics and vaccines; collaborations through the International Health Regulations (IHR 2005); and shared genomic databases for bacteria and viruses.