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Greetings from Axios Future, where tomorrow never knows.

1 big thing: The coronavirus — we should have seen it coming

Illustration: Sarah Grillo/Axios

The novel coronavirus outbreak has caught the U.S. and the world off guard, and it now threatens to break through all containment efforts. But far from being a surprise, the potential pandemic was utterly predictable.

The big picture: The world had its chance to prepare. We failed — and now we'll pay the price.

Flashback: Last October the Johns Hopkins Center for Health Security (JHCHS) put on a high-level pandemic simulation focusing on a fictional global outbreak caused by a novel coronavirus that spilled over from animals to humans.

  • Called Event 201, the exercise brought together policymakers and disease experts to debate how they would respond to the simulated pandemic, in an effort to map out how they could combat a real one.

Along with other reporters, I was there to observe the proceedings. What happened during the fictional pandemic eerily presaged the challenges and conundrums the world is facing with COVID-19.

  • Participants representing governments agonized about whether to ban public gatherings and block travel from infected areas.
  • Misinformation — accidental and deliberate — spread over social media, and participants in the exercise struggled to control messaging.
  • The economic blowback from attempts to control the pandemic was as devastating as the disease itself, a dilemma compounded by the fact that participants had to make vital decisions with imperfect information about the virus — just as officials must do today with COVID-19.

The final results of the Event 201 simulation were horrific, with 65 million people dying in the exercise.

Why it matters: There's no way of knowing yet whether COVID-19 can cause damage on anything close to that scale. But Event 201 and other predictions about the rising threat from new infectious disease gave us plenty of warning about what the world is facing today.

  • Despite that, in the years before the coronavirus outbreak, the Trump White House dismantled the National Security Council's global health security unit and drastically cut the CDC's global health section.
  • Local health departments lost more than 55,000 workers between 2008 and 2018, according to the Trust for America's Health.
  • "There are major global vulnerabilities and challenges in pandemic preparedness and it will require collaboration between global business, governments and international organizations to address them," said Tom Inglesby, director of JHCHS.

If the current coronavirus can't be contained, the world will be forced to mitigate it as best it can. But few countries are adequately prepared for what would come next — including the U.S.

  • Problems with tests have slowed the diagnosis of suspected cases in the U.S., giving the virus time to gain a foothold.
  • HHS official Robert Kadlec told a Senate hearing on March 2 that the U.S. had just 10% of the respiratory masks needed to combat a "full-blown" pandemic.
  • "At this point, it's tricky to think that this will be kept from becoming endemic," said Jonathan Quick, a former WHO official and the author of "The End of Epidemics."

The bottom line: Too often our response to public health disasters cycles between "crisis and complacency," in the words of a 2019 report from the Center for Strategic and International Studies. But we can see these catastrophes coming all too well.

2. Robots on the front line of coronavirus outbreak

Xenex robot uses ultraviolet light to kill germs like coronavirus. Photo: Xenex

As coronavirus spreads across the globe, health care professionals are tapping germ-zapping robots and roving tele-doctors to help minimize human exposure to the virus, Axios' Joann Muller writes.

Why it matters: Drones and other new technologies could potentially slow the spread of illness and perhaps speed the delivery of medicines and other support where help is needed.

  • But deploying them comes with a host of ethical questions.

What's happening: Hundreds of hospitals already use robots to disinfect operating rooms and kill MRSA and other pathogens that cause health care-associated infections.

Now they want to turn them on the coronavirus, too.

  • A UV emitting robot from Xenex Disinfection Services is deployed in more than 500 hospitals worldwide, including ones in California and Nebraska where there are confirmed cases of coronavirus, to destroy germs. (It still needs to be tested on the novel coronavirus.)
  • GermFalcon, a UV robot that targets germs on airplanes, is fielding inquiries from multiple airlines, said co-founder Elliot Kreitenberg. Now he's developing a similar UV robot for hospitals.
  • Vici, a device that looks like a tablet on wheels, enabled doctors to interact with the first U.S. coronavirus patient at a hospital in Everett, Washington, according to Forbes.

What to watch: Drones and unmanned aerial vehicles can now perform a variety of tasks that could be beneficial in fighting epidemics.

  • Drones still face regulatory hurdles in the U.S., but if the FAA eventually permits them to fly longer distances, a network of distribution centers could quickly send vaccines via drone, said Justin Hamilton, a spokesperson for Zipline, a drone company that makes thousands of deliveries per day of blood and other medical supplies in Rwanda.

Yes, but: The temptation during a humanitarian crisis might be to rush technologies to the scene before they're ready, even bending regulations to do so, which would be a mistake, disaster recovery experts warn.

  • "You don't want to experiment on people and make things worse," said Robin Murphy of Texas A&M University.

Go deeper.

3. Another new first for CRISPR

Illustration: Aïda Amer/Axios

For the first time, scientists have used the gene-editing technique CRISPR inside the body of an adult patient, in an effort to cure congenital blindness.

Why it matters: CRISPR has already been used to edit cells outside a human body, which are then reinfused into the patient.

  • But the new study could open the door to using gene editing to treat incurable conditions that involve cells that can't be removed from the body, like Huntington's disease and dementia.

Details: The research was sponsored by biotech companies Editas Medicine of Cambridge, Massachusetts, and Allergan of Dublin, Ireland, and was carried out at Oregon Health and Science University.

  • Scientists led by Eric Pierce of Harvard Medical School injected microscopic droplets carrying a benign virus into the eye of a nearly blind patient suffering from the genetic disorder Leber congenital amaurosis.
  • The virus had been engineered to instruct the cells to create CRISPR machinery. The hope is that CRISPR will edit out the genetic defects that cause blindness, restoring at least some vision.
  • "We literally have the potential to take people who are essentially blind and make them see," Charles Albright, chief scientific officer at Editas, told AP.

"It gives us hope that we could extend that to lots of other diseases — if it works and if it's safe," National Institutes of Health director Francis Collins told NPR.

Go deeper: Genetic technology's double-edged sword

4. What Matters 2020: Automation and the future of work
Credit: Axios Visuals

As part of our What Matters 2020 series on the critical trends that will outlive this moment, Axios' Jim VandeHei and Mike Allen taped seven short videos discussing topics of consequence to society.

Watch the video.

5. Worthy of your time

Live facial recognition is a fact of life in Buenos Aires (Dave Gershgorn — OneZero)

  • Police in the Argentinian capital are using real-time facial recognition systems— with mixed results for safety and civil liberties.

The great Tulsa remote working experiment (Sarah Holder — CityLab)

  • The Oklahoma city is responding to declining population by paying people thousands of dollars to move there and work remotely.

Must growth doom the planet? (Ted Nordhaus — The New Atlantis)

  • Far from worrying about the environment effects of endless growth, the real challenge will be coming to grips with stagnation.

COVID-19 is traveling along the new Silk Road (Parag Khanna — Wired)

  • Just as the Black Death spread from China to Europe through 14th century trade routes, the new coronavirus outbreak reflects modern-day interconnections.
6. 1 gambling thing: Long Bets

Photo: Nicholas Free/Getty Images

A group of futurists have been making long-term bets with each other about how the world will develop — and in 2020, some of them are coming due.

The Long Now Foundation is a San Francisco-based organization that aims to foster long-term thinking.

  • Very long — among the group's projects is a 10,000-Year Clock being built in a Texas mountain that, when completed, will keep time for the next 10 millennia.

Long Now also sponsors what are called Long Bets — competitive wagers about whether or not a specific event will occur by a specific time in the future, with the winning money going to charity.

  • In 2008, Warren Buffet bet the investment fund Protégé Partners that by the end of 2017, the S&P 500 would outperform hedge funds. (Buffett won.)

What's new: A number of these Long Bets will be decided over the next year, as Ahmed Kabil and Alice Riddell detailed in a Medium post.

  • One has already been decided: In 2002, science writer John Horgan bet theoretical physicist Michio Kaku $2,000 that by 2020 no one will have won a Nobel Prize for superstring theory, membrane theory or some other unified theory describing all the forces of nature. Horgan was right.
  • Among the bets that will be decided by the end of the year is whether a major U.S. pro sports team will have a female player, and (less happily) whether bioterror or bioerror will lead to a million casualties in a single event over a six-month period.

The bottom line: It's too easy to spout predictions about how the world will be in 20 years (except in this newsletter, of course), but putting a little money on the table can inject a note of welcome caution.