Texas A&M disaster expert: Aerial photos of Chinese parking lots could've flagged COVID last year

Last week, in the journal “Foreign Affairs,” you called for an early-warning system able to spot pandemics-in-the-making. What makes you believe that’s possible?

After the Ethiopian famine killed almost a million people, in AID we set up the Famine Early Warning System, called FEWS. In the humanitarian world, it’s very well known and well respected.

What it does is take aerial photos of ground cover in famine-prone areas of the world, then compares one year to the next. So they’ll look at June 1 in, let’s say, South Sudan in 2018 and in 2019. If it’s green one year and brown the next, they can assume that the crop may have failed. Then they send teams in on the ground to check out what’s going on.

That system has succeeded, along with the rest of the humanitarian response system, in substantially reducing the number of famine deaths. Alex de Waal, a scholar at Tufts, is one of the leading experts in the world on famine. Two years ago, in his book “Mass Starvation,” he looked at famine deaths over the last 150 years. He said it’s very clear there’s been a substantial reduction in starvation deaths. Famines’ death toll is dramatically lower than in the past. One reason is that we have an early warning system, FEWS.

FEWS doesn’t just tell people in USAID the famine is coming. We tell the whole world. It’s open-source information. Tens of thousands of humanitarian-aid workers, governments, churches, religious institutions, NGOs and UN agencies get these reports every couple of weeks and can see where the hotspots are.

I’m proposing that we use the same methodology for a disease early-warning system.

How would that work? Can you see a disease outbreak from a satellite?

Yes. I wrote the article proposing the system and sent it in to “Foreign Affairs,” and then an article appeared from Harvard with very interesting research. They looked in China at a hospital parking lots and health clinic parking lots to see how many people were going into the clinic. You can do that from satellite photographs, which the Chinese government has no control over. If a parking lot has got two cars in it for the preceding two months, but all of a sudden it has 100 cars, you can assume something’s going on. And if that’s not just in one clinic, or one hospital, but all the hospitals in the area, something’s wrong.

Now, it doesn't mean you can identify the disease. But the Harvard scientists who did this also looked at the Internet. You can buy commercially aggregated anonymized data that show search terms, people asking questions about particular symptoms of disease that they're experiencing. Beginning in August of last year, they were querying exactly the same symptoms of COVID-19.

Now, they also found that the number of people at the parking lots in these clinics in the greater Washington area started increasing last August, along with all of this traffic on the Internet about symptoms.

So if you marry those two pieces of information from electronic media and satellite photographs, you can assume something bad is going on.

You can also look for other things from the air, whether mass graves are being dug or whether the crematoriums are working overtime to incinerate bodies of people that have died. If they’re working all day and all night long, you can assume the death rate is much higher than usual.

This kind of research has been done about Iran. It was the third or fourth place that the pandemic hit very hard. There were mass graves being dug outside of Qom, one of the major cities that was affected, and aerial photographs showed the mass graves and the people being buried.

And there are a lot of other things that satellites and electronic media can tell us about what’s going on without having anyone on the ground. For instance, during the Bosnian Civil War, the CIA took aerial photographs of an area with high heat signature. It was 10,000 bodies of young men and boys that had been massacred during the civil war. Their bodies were decomposing. When bodies decompose, they give off heat, and if you have enough of them, you can actually tell that from a satellite.

Are there particular places where outbreaks are more likely to begin?

Before COVID-19 struck, the RAND Corporation, a respected U.S. think tank, did a study about where future epidemics are likely to start. They're almost all in countries with weak or nonexistent health systems.

Seventy percent of all of the new diseases that have affected people in the last 40 years are “zoonotic diseases,” animal diseases that make the jump from animals to people. Then they mutate so that they can efficiently spread from one person to another. Then all of a sudden we have an outbreak of a disease, which becomes an epidemic and then that becomes a pandemic. Very few become a pandemic; many become epidemics.

In any society where people eat a lot of monkey — it's called bushmeat, which means wild animal meat — you have a risk of a crossover, because the wild animals may actually have these diseases. There’s broad consensus that this coronavirus came from what's called a “horseshoe bat,” which lives in caves that are about 1,000 miles south of Wuhan.

The second thing is, a lot of people in poor countries live with their animals, which are a source of risk. For example, some scientists think the MERS coronavirus — Middle East Respiratory Syndrome coronavirus — probably came from camels. HIV/AIDS probably came from monkeys.

So assuming that we can get an early warning, what then? How would that warning help?

We don't want these zoonotic diseases to make the jump to people, but there's not a lot we can do to stop that. What we can do is discover the outbreak early enough to send teams in to stop the outbreak from spreading.

That’s what happened in West Africa when an Ebola outbreak started in 2014. Medecins Sans Frontieres — Doctors Without Borders, a French nongovernmental organization — said publicly, “We cannot contain this.”

I couldn’t believe it when they said it. They said that the only thing that could be done was for the U.S. government to intervene with the U.S. military and USAID, and that's what President Obama eventually decided to do. I think he waited too long to do it, but he did do it.

They sent Disaster Assistance Response Teams — DART teams — from U.S. AID. DART teams, by the way, were invented under Bush 41, when I was running the emergency functions at AID. We first deployed them in the summer of 1989. Now they’ve been sent around the world to contain disasters before they get out of control.

They’re usually successful. Our biggest problem is when there's a civil war going on. An outbreak is hard to contain then, because of the violence. But for Ebola we did go in, and we eventually contained the outbreak in those three countries, Liberia, Sierra Leone and Guinea.

Who would run an early warning system?

Now some people will say, we should vest this in an international organization. There are advocates who say it should be in the World Health Organization.

The World Health Organization already has an early warning system. It's not based on satellite photographs and electronic media. It's basically people on the ground saying, “Something bad is happening, and now you need to intervene.”

The problem is, it doesn't work. It does report that something's wrong, but no action is taken.

The reason is this: When the World Health Organization was set up in 1946, they made a terrible decision to allow all the regional offices to elect their own director generals an deputy director generals who do not report to the director general in Geneva, Switzerland, where the headquarters is. They report to the board of directors, which means they don't report to anyone.

They're independent entities, and they have veto power over the headquarters intervening. It's as though one of our regional battalion leaders somewhere in Afghanistan says, “Well, I don't really think we want to do this. I want to tell the president of the United States that he has no authority over me and cannot order me to do anything.”

When the Ebola outbreak took place in West Africa six years ago, the World Health Organization’s headquarters wanted to send teams in to stop it, but the regional office said, “No, that will damage the economy — there might be shutdowns — so we're not going to let the teams come in here. We're not even going even to announce that it’s a disaster.” And they prevented a response.

With respect to COVID-19, China does not want the teams in. The existing early warning systems don’t work in a dictatorship, which China is. They suppress information. In a democracy, there are so many different ways of getting information that it's almost impossible, when you have an outbreak like this, to suppress it. In a dictatorship, you can.

Amartya Sen, at Harvard, is one of the greatest economists of famine in the world. He once said that there's never been a famine in a democracy. A lot of people attack that idea, but I believe that basically he’s right.

Why? Because you can tell a famine is starting six months before it actually starts killing people. In a democracy when people start panicking about the food supply, someone sounds the alarm: the members of parliament or Congress or the news media or the religious institutions or the nongovernmental organizations. Civil society began sounding the alarm.

Well, in a dictatorship you don't have a free media. You don't have religious institutions to say that. You don't have NGOs that are independent. The biggest risk, it seems to me, is in dictatorships that suppress information.

I don't actually think the Chinese government knew last August that this was happening. If this Harvard study is correct, and I think it is, I think the local official said, “Oh, we don’t want to send bad news to Beijing.”

And no one else was blowing the whistle because there is no one else to blow the whistle. So as a result, the Chinese government probably didn't find out until December. Then they even delayed blowing the whistle again.

We need a system to help all of us — the whole world — to be alerted way earlier.

When you say, “We need a system,” do you mean that the United States needs a system? Who would run this?

My friends in New York say, “Oh, Andrew, we need to invest this in an international organization.”

Well, I’ve worked with the United Nations for 30 years off and on, and they do some very good work. The World Food Program is the best UN agency. UNICEF is an excellent UN agency. So is UNHCR, United Nations High Commission of Refugees. But a lot of other UN agencies are very dysfunctional.

And WHO has been dysfunctional for a long time. We set up the Global Fund to deal with HIV/AIDS outside of WHO, and we set up the Global Alliance for Vaccines and Immunizations outside of WHO. That was because the donor governments and the developing countries did not have confidence that WHO could manage them.

WHO does some very good work in terms of setting standards an testing different things, but in terms of emergency response they have not been very good, frankly. So what I'm saying is, we need redundancy. We need to have early warning systems — multiple early warning systems — because if we invest all of our eggs in one humanitarian basket and that system fails, then all of us are going to have another mess like the one we have right now.

So I think WHO should have the early warning system, but we also need to have one here. I think the Europeans should have one. What having multiple systems does is, it creates competition. It puts pressure on everybody not to suppress information, pressures them to get out accurate information early on.

I'd rather have someone sound the alarm when it’s really not a potential pandemic than do the opposite and say nothing.

I'm interested to hear you say that democracies are good at early response. But the United States is now the center of the global pandemic. So are there also problems with a democracy when it comes to response?

I did not say “response.” I said “early warning.”

What’s the difference?

The difference is, we did know very early on this was hitting us, once we found out that it was going on in China. But there were several problems.

The federal government has not done a good job running this. The states are competing with each other and bidding up the price of tests. The same thing is happening with respect to face masks and personal protective equipment. They shouldn’t be doing that. There should be a national contract, and in a crisis the states should be able to buy through a system that's organized nationally.

I'm a federalist. I believe in state and local government. I think the country's too big for most public services to be offered at the national level; they need to be offered the state and local level. However, when there is an emergency of this magnitude — one that threatens the economy of the United States, that has caused the devastation that this is causing — it seems to me we need to have a more active role at the federal level than we have.

Why do you think the federal government hasn’t played a more central role?

For 200 years there has been debate about the role of the federal government in public health. In 1824, John Marshall — the second Chief Justice, and probably the most famous and most important Chief Justice of the Supreme Court — wrote a decision that’s still used now. It says, one, that public health, including quarantines, are a function of state and local government, not the federal government. Two, the federal government does have the right in a public health emergency to control the borders of the United States and the borders between states. So the federal government can intervene between states but not within states.

This is not a new decision from some liberal justice. John Marshall was not a liberal justice. Yeah, people are suspicious of the Supreme Court. But this predates the word “liberal.” “Liberal” wasn't even used in those days, didn't exist in those days. This is the law of the land.

It’s been the law for 200 years that the state and local governments have the authority to protect the public health through things like quarantines.

At that point they did not use face masks because in those days they didn't have the medical science that we do. Now, with respect to COVID-19, there’s a lot we still don't know about this disease. But we do know that face masks work.

There’s been an unfortunate debate about this from the beginning. There have been confusing signals from the federal government. Even CDC at first said, “Don't buy face masks.” That was a mistake because it confused the public. People think: “Why did you say we shouldn’t have them then but we should now?”

If you want the public to agree voluntarily to a policy, you need to send consistent messaging from everybody from the beginning. We did not do that.

There is a problem with a federal system in a national disaster. Part of the U.S. Constitution says that when we’re in a war, the national government has enormous power. During a war, the United States can suspend the writ of habeas corpus, one of our most basic rights in the judicial system.

Well, we are in a sort of a war right now. People are debating this question of whether we should shut down. I don't believe we should shut down. Enormous damage is done by an economic shutdown, much of it to poor people. They lose their jobs. They don't have income. And at the federal level we’re borrowing trillions of dollars. Is anyone looking at the consequences of this debt on the economy of the United States going forward?

Shutting down is not the answer. The answer is obviously a vaccine or a drug that will kill the disease. But in the interim, the answer is face masks and social distancing and avoiding people in closed areas like bars.

So you believe that a democracy as ornery as the United States could reopen safely with the right leadership? One that puts more health measures into place?

I do. I’m not opposed to bars, but when people drink, what do they do? Their discipline breaks down, and younger people think they're invulnerable to this because the death rate is so low — which is true — but what they're not thinking about is the damage done to survivors’ lungs. Or about brain damage: People lose their sense of tastes and smells because of damage to our brain.

The messaging has been wrong. People are only looking at mortality rates. They should be looking at the the effects of the disease itself.

Is there anything else that you want Houston or Texas to be thinking about right now?

Friends of mine have said, “I don't need the government telling me to wear a face mask. I resent it. It's an intrusion on my liberty.”

Well, actually, during a public health emergency, the government has the right to do that. The Supreme Court decided that 200 years ago. It's not new. Gov. Abbott has the authority to intervene on face masks, and in my view, he made the right decisions, even though they’re very controversial.

In terms of liberty, you do not have the right to infect me and potentially kill me and my family and your own family. Thirty percent of the people who get COVID-19 have no symptoms but can infect other people. If you don't know you're sick, you don't stay at home and self-quarantine. You walk around the streets, you go to the store, you talk to your friends. So people who don't know they're sick are affecting the rights of other people.

No one would say that someone has the right to drink and drive because when you’re drunk at the wheel of a car, you can kill people. That's why every state prohibits drinking and driving, and they should.

The same argument goes for face masks. We know face masks work. A whole bunch of studies show it. And it's not a matter of you protecting yourself; it's a matter of you infecting other people.

Everybody should be required to wear a face mask. But that is a decision to be made at the state level and the local level. It should not be federal. The country's too big to have policies like that.

Nationally our political leaders in both parties, liberals and conservatives, should be making examples of themselves and modeling good behavior. One of my heroes, Theodore Roosevelt, said that the presidency is a “bully pulpit.” We don’t have to force people, but we should lead by example.

Oh, and there's one last thing I want to say: I've known some very strong libertarians, and I respect the libertarian tradition and the people focused on protecting liberty. Liberty is part of what America is all about.

But I've noticed that libertarians change their views on face masks when they get sick from the disease themselves, or when they find out that they had the disease and didn't know it. They infect their spouse, or their children or grandchildren, and someone dies. Then they're in shock. And all of a sudden, their views on face masks change.

As more people get infected, we’ll see a change in public opinion. But it shouldn't have to come to that. People should be taking the precautions now. If everybody in Texas was wearing a face mask right now, we could contain this outbreak without closing the economy down.

This interview has been edited for length and clarity.

This is all meaningless when you have a president who fires the pandemic team and denies the virus as a hoax for several months.

But someday we might have an intelligent president and Democrat-controlled Senate. It would be great to have someone working on setting this up while the election is ongoing so that it could be implemented beginning next year.

DJT didn't even bother to have vetted lists of candidates for appointments before his inauguration. Biden and his team know better than to wait until January. I'm betting they already have wonks working on legislative proposals.

It's a great idea but it won't work if the lying dictatorships like Russia are allowed to buy and control the U.S. government, which Trump and the Republicans give them.

Trump is behaving like a dictator now, completely corrupting the pandemic response. He's shutting down testing to hide the numbers, just like China and Russia have and he's withholding COVID resources from blue states while manipulating the stock market for personal and crony gain.

Yeah

I respect this doctor for setting up those agencies and explaining how they knew in fucking AUGUST of last year that shit was going down.

You notice how he called out Obama BY NAME regarding Ebola? Yet refuses to say anything negative about the shitgibbon BY NAME? He just says, "the federal government".

Fucking waffling libertardian coward.

Thanks for posting that, OP. Gotta agree with r16 about his waffling libertarian comments