Covid-19: Facing the Uncertainties

A reflection on uncertainties from a post of ours first published on 5 May 2020

The Great German strategist Helmuth Von Moltke encapsulated uncertainty as follows:

“No plan of operations extends with any certainty beyond the first contact with the main hostile force”. 

In the arena of respiratory infectious agents, Moltke’s ‘tactical genius’ could aid our current thinking.

Moltke thought it was only possible to plan the beginning of a military operation.  What he meant is that leaders cannot foresee the future and therefore need flexibility in their planning, as the uncertain will always happen.

The uncertainties

We have no idea how many respiratory agents there are. Since 1970, 1500 pathogens have been discovered. 70 per cent of these have come from animals. Some authors report that up 40 per cent of respiratory infections have no recognised causes.

In our analysis of the RCGP surveillance data  (week 17 of 2020), out of 428 samples, 353 (83%) were unknown agents, and only 75 (17.5%) were positive for SARS-CoV-2. We have consistently reported variable numbers of samp…