Pandemics and the way you should examine them

A global pandemic is probably the first intuition when thinking about causing human extinction. However activists might be disappointed after a brief study of past pandemics and their consequences. Everybody knows that pandemics broke out throughout history and obviously none of them wiped out the human race. But this fact doesn't classify them as irrelevant, because when inspecting the dynamics of past pandemics we must examine much more than the final outcome. And more importantly, we must remember that they were all caused by natural occurrences, and didn't involve several simultaneous pathogens enhanced by modern genetic engineering tools, as we suggest in the text about pathogens.

In this document we focus on a range of external conditions influencing the final outcome, and they are many. Probably, the most intuitive factor is the pathogen’s traits, however, the same pathogens, spread in different areas, or in a different time, can cause whole different results. That is since other factors have significant influence on the end result. These include elements such as population density, population mobility, populations’ natural immunity, whether there were other recent diseases outbreaks in the area, the area's medicine level, the area's readiness for states of emergency, the season, climate change, food and drugs reserves, and many others.

Many relevant factors have changed dramatically since the outbreak of the major pandemics in history. Two prominent ones are advancements in medicine and in hygiene, both highly reduce the chances of a global scale pandemic. However, two other prominent factors have also changed dramatically since the outbreak of past pandemics – human density and human mobility.
Another prominent factor to consider which haven’t changed much along history is the human factor, meaning how economic and political matters always play a major part in any decision, no matter what’s at stake.

The factor of density is much more meaningful today than it was in the past, since humans spend much more time in closed areas, and since the population is much denser than in the past. Modern density offers pathogens a range of opportunities which were absent in the past, as the more humans per square mile, the easier it is for a microorganism to pass from one human to another. Nowadays, more than ever before, humans can pass pathogens to other humans in hundreds of ways, every minute of every day, by touching, breathing upon one another, preparing food, defecating or urinating in public toilets, by producing enormous quantities of waste that could serve as food for many vectors, by creating cisterns of rain water which serve as bedding pools for disease-carrying mosquitoes. We are mentioning aspects of modernity which are known to enhance disease spread (knowing that some are much more relevant and significant than others), not only since it’s a highly relevant factor when examining past pandemics in comparison to the desired future one, but also since we encourage other activists to consider relying on several pathogens, and if possible, each with a different method of distribution, to ensure maximum spread and contagion. In any case, the crucial thing to consider is that once pathogens reach new locations, the dense human population and urbanization ensures that even relatively poorly transmissible pathogens face ever-improving statistical odds of being spread from person to person.
In today’s population density levels, when most of humanity lives in highly dense cities, if an airborne and rapidly transmitted pathogen such as smallpox spreads for its first time, it would probably cause a much bigger effect than smallpox ever did in the past. So when examining past pandemics we shouldn’t only look at what happened but also at what could have happened under different conditions.

Mobility is an even more significant factor than population density. Most of the pandemics broke in times when the human race was significantly more confined to one place. With more than 4 billion passengers traveling by air every year, which is about one billion more than they were just a few years ago, with around 100,000 flights per day and about 10 million humans traveling from place to place, with about 3 million people who cross international borders every single day, nowadays the pathogens’ distribution potential is incomparable in relation to the times of the big pandemics outbreaks. There was never a time in the history of the human race when a pathogen could travel around the world as fast as it can today. Past pandemics rarely traveled faster than 2 kilometers a day. Nowadays, long before anyone could suspect the presence of a new disease, infected humans would be traveling thousands of kilometers a day, crossing countries, and then the pathogens would further expand within each densely populated city the infected ones reach. Due to changes in humanity way of life, pathogens no longer remain confined to remote ecospheres or rare reservoir species – for them, the earth had truly become a global village.

SARS is obviously not a relevant option for our mission, however it is a relevant example for the dramatic role mobility plays in pandemics.
The SARS pandemic started with one man who got infected at the rural Chinese province of Guangdong, in November 2002. Soon, many people in that province got infected but the disease probably didn’t spread out of Guangdong to that point. In late February 2003 a physician who treated people with atypical pneumonia (not knowing yet it was something else, later called SARS) got infected and unknowingly dispersed the disease outside Guangdong to Hong Kong, where he infected at least 6 people at the hotel he stayed in. Three of them were from Singapore and one was from Canada, each brought the pandemic to their country. The fifth person, a local Hong Kong resident, went to the hospital and caused a huge outbreak in Hong Kong, and the sixth is an Asian-American business man who brought the disease to Hanoi (Vietnam) where he infected at least half of the health care workers who treated him. Eventually the disease spread to 26 countries in 3 months and to 5 continents in 5 months.

Overcoming SARS revealed technical and scientific capacity but it also had to do with luck and for several reasons:
A disease spread by droplets isn’t really very rapidly transmitted.
As opposed to influenza and many other diseases, SARS’s symptoms tend to appear before, rather than after, the infected hosts become highly infectious. That allowed many SARS cases to be recognized, hospitalized and placed in isolation before they reached their peak of infectivity.
The disease began to spread globally in the spring which is normally the beginning of the end of the flu season, which made it easier for medical systems to detect it (arriving in unusual timing) and also to focus on it.

SARS was spread unintentionally by infected people who didn’t know they carry it. Think how fast pathogens can be spread if the course of events is not left to chance and instead is determined by elaborated planning such as spreading several different pathogens in several different locations.

Even back at 1918 when humans' mobility was much less intensive and extensive than today's, it still was a major factor in the Spanish flu outbreak which passed through Northern America, Europe, Asia, Africa, and the South Pacific by trade routes, shipping lines and of course the First World War which accelerated the spread of the disease as a result of the mass movements of soldiers.
Experts say that if there was a smallpox outbreak today it would, due to modern travel, spread across the world in 6 weeks only.

The Spanish flu also serves as a good example of the earlier mentioned human factor. The flu is called Spanish not because it started in Spain and not because it affected Spain more than other countries, but because Spain was one of the few countries that didn't take part in the First World War, and so didn’t have the political incentive to conceal the disease like the rest of the countries (who didn't want their enemies to know they were struck by the disease).
This concealing of the disease is one of the reasons that allowed it to spread as it did. The population was not informed of the pandemic and there were no steps taken to control it. To prevent what might have been a military disadvantage, the politicians preferred to deceive their citizens and soldiers and actually murder them, since obviously, everything is better than to show signs of weakness.

Another example proving that there are many other factors taken into consideration and even actually directing the course of action in emergency situations other than the safest and fastest way to end and control the epidemic, occurred in a plague outbreak in India in 1994.
What determined the actions taken were financial and political interests, not public health. Some of the actions actually accelerated the spread, instead of helping to control it.
The Indian authorities censored the information regarding the epidemic trying to significantly minimize reports regarding the scope and severity of the plague. They didn’t want the epidemic to affect tourism (especially since it was just before the holiday season) which is a major financial business in India. The Indian authorities also refused to seal the area of the epidemic so workers would come to work and the production wouldn’t be harmed.
For political reasons, local leaders did not take early action to stop the outbreak, since plague is largely a disease connected to the slum-living poor.
And when people heard rumors that the city of Surat (one of the places stricken by the epidemic) would be quarantined, over 300,000 people deserted the city in two days, some were already infected with plague. Pharmacists and physicians bought large amounts of antibiotics and left the city with their families and the medications. The entire stock of tetracycline (antibiotic that is used to treat plague) was depleted within hours, and many nurses and physicians did not come to work, so people who could not leave the city were left with no treatment at all.
This was a very small epidemic, not many people were killed or infected but still all the systems have collapsed. There was no rational thinking, no caring for others, no fellowship and no organized management. As always money and political interests come first.

Even in the case of the earlier mentioned SARS pandemic, the human factor played its role. The first case of SARS was revealed in china in November 2002, but the Chinese did not inform the World Health Organization (WHO) that an epidemic might be starting until February 2003, for political and financial reasons, fearing the same reactions that took place in the plague outbreak in India 8 years earlier

The Ebola outbreak of 2014 sets as another example of humanity’s typical administration of pandemics.
There was a significant delay of several months in the institutions’ response to the outbreak, due to factors other than public health, allowing the virus to spread.
The WHO significantly lacked when it came to resources, as core funding of this UN body has eroded over decades, mainly due to the demands of the member states that make up its executive board to prioritize lifestyle-related diseases such as cardio-vascular conditions and diabetes, over infectious ones.

Another main reason why the Ebola outbreak wasn’t prioritized, even though it was the first time Ebola emerged in a large dense city, is that the African regional WHO office was full of political appointees. Its director is directly elected by Africa’s ministers of health, who partly fund the office, and is therefore dependent on them. And of course, no country wants to declare an Ebola epidemic, because of the economic implications.
The WHO’s Geneva headquarters shared the same state of mind. They know how dependent they are on these governments' cooperation. Internal memos warning about the future spread of the virus also went on to say that even convening an emergency committee to discuss the issue "could be seen as a hostile act".

Only after major publicity in western media regarding the infection of two American health workers who were repatriated for treatment, a more significant confrontation took place.

There is no doubt that the medicament technology was improved along the years but from many other significant aspects pandemics are much more dangerous than ever.
Countries don’t hold enough drugs to deal with a pandemic and have difficulty producing and administering vaccines quickly enough to fight it.
If a pandemic of influenza breaks it would take more than a year to vaccinate less than a half of the human population. Given the limited medicinal resources, if there is an outbreak of a number of pathogens at once then the time frame for vaccine production would obviously be significantly longer. And even that estimation is relevant only in cases when the vaccines are already known.
Also the health systems don’t have enough medical teams and enough places and machinery to accommodate the sick. In the US between 80% and 90% of the medical ventilators are in use at any given time (and during a routine influenza season even more than that) which leaves no medical ventilators to be used in a time of a pandemic.
Based on the far and recent pandemic cases, the drugs would be depleted and many health care professionals would not stay to treat the sick fearing they might infect themselves and their own families. Countries may not join forces but the other way around, money and power will dictate the actions taken more than the concern for each human.

Another aspect that should be taken into consideration from the medical perspective is the population immunity. In the 17th century when more European waves of conquers reached further into the Americas, up to 95% of its native population was wiped out (in some places 100%) by the diseases the conquers brought with them. The natives mostly died of smallpox, a disease they never met before and therefore were not immune to.
There is a vaccine for smallpox for a number of decades now, but since the disease is considered eradicated (meaning that it no longer exists in nature) the population is not vaccinated for it. The fact that the population was also never exposed to the disease means humans are not immune. However, we don’t specify this example so that you would focus on smallpox, but to exemplify the tremendous impact on a population in the case of an unfamiliar pathogen.

Some experts argue that humanity preparedness today is in no better state than it was in the times of the big pandemic outbreaks.
Dr. Richard Johnson of Johns Hopkins University arguers that in the case of a big pandemic outbreak like the Spanish flu for instance, the systems would collapse and the ability to stop the spread won’t be much better than it was in 1918.
According to Dr. Michael T. Osterholm, Director for the Center for Infectious Disease Research & Policy (CIDRAP), we’re not in a much better shape today. He explains why 21st century medical advances are not expected to be significant in the next pandemic: "We really have no armamentarium today that is any different on a whole than what we had 100 years ago, at least in terms of what’s available to the world’s population. We have vaccines, we have some antiviral, but they will be in such insufficient quantities as to be what we like to say filling Lake Superior with a garden hose in overall impact".

Some factors, characteristic to this era, don’t only accelerate diseases, but can also cause old ones – which humans thought were already eradicated – to come back, as well as new ones to emerge.
Numerous diseases that were once controlled or limited through drugs or containment strategies, are making a comeback. Among them: cholera, diphtheria, giardiasis, viral hepatitis, malaria, measles, pertussis, pneumonic plague, tuberculosis and viral encephalitis. In many cases, these diseases are making a comeback because they have outsmarted the vaccines that were developed to control them. Tuberculosis is a case in point.
After effective treatments were developed in the 50’s, the disease had been considered as beaten. But since the late 80’s, there has been a worldwide increase in the number of new cases. This is because Tuberculosis was evolving all the time, becoming resistant to the existing treatments.
In 1993 the WHO declared Tuberculosis a global emergency which continues to this very day with around 60% of the cases of multidrug resistant Tuberculosis occurring in Brazil, China, India, Russian Federation and South Africa.

Usually antibiotics kill off 99% of the bacteria, leaving a vast nutrient-filled “petri dish” free of competitors for the surviving antibiotic-resistant bacteria which rapidly multiply and spread out new antibiotic-resistant population. Humans simply accelerated the natural process of evolution by exposing billions of microbes at a time to various chemicals. Furthermore, often the genetic changes the microbes underwent overcoming the antibiotics, offered unexpected additional advantages, enhancing the bacteria’s ability to withstand wider temperature variations, or outwit more elements of the host immune system.
Besides that it gives the bacteria an extensive ground for genetic variability, the repeated use of antimicrobial drugs can reduce the number of good bacteria in the body, weakening the immune system.

MRSA – Methicillin Resistant Staphylococcus Aureus is probably the most widespread and best known ‘superbug’. The first outbreak occurred in one hospital and quickly went global, favoring hospitals. Part of the reasons is related to the ‘five C’s’ posited by the CDC as greatly increasing the risk of MRSA: Crowding, Contact, Cleanliness, Compromised skin and Contaminated personal care items. At least 4 of these 5 factors have intensified over the years and are much more relevant today than they were in times of the major outbreaks.

Hospitals are hazardous places because they crowd together overmedicated sick people with battered immune systems, which is obviously the optimal environment for bacteria, viruses and fungi.
Hospitals can become epicenters of infectious outbreaks that can move into the community and this, as counterintuitive as it maybe, is another relevant difference between the times of the major outbreaks and our time. Hospitals play a major part in pathogens traffic. In addition, about 70% of all hospital-acquired infections are now resistant to the standard drugs used to treat them.
The indiscriminate use of antibiotics to fight microbes has created stronger and more resistant hospital invaders. Clostridium Difficile, a bacterial colon invader, can survive up to five months on a hospital floor. Hepatitis B virus can contaminate electroencephalographic electrodes for up to seven days. E.coli which accounts for 12% of all blood poisoning in hospitals, does very well on plastic surfaces. Salmonella Enteritidis, a classic immune system buster, can arrive in hospital food. A group of fungal invaders, members of the Candida genus, are now the fourth most common bloodstream pathogen in hospitals.

Don’t get this point the wrong way, we are not saying that modern medicine is actually an advantage for our mission, but that it is far from being bullet-proof and has many crucial disadvantages as well.

MRSA is far from being anything relevant for our mission in general (though it has at least one very desirable trait – it can live on any surface and is almost as hardy as anthrax), but it is relevant for the case we are making here, as it is, in some ways, a predominantly 21st century disease. It first emerged in modern hospitals, due to overuse of antibiotics, and it is now spread in hospitals, schools, nursing homes, day-care centers, sports centers, military bases and jails, due to humanity’s crowding, contact, cleanliness, compromised skin and contaminated personal care items.

During the 60’s and 70’s humanity thought that diseases are under its control. Not only that many diseases have appeared since then, such as AIDS, Ebola, Marburg, Lassa, SARS and many more, in 1982 scientists have discovered that there is even another form of infection called Prions. These are aberrant forms of proteins which are able to cause a number of diseases such as the CJD and Kuru, fatal familial insomnia and extremely rare Gerstmann – straussler Scheinker syndrome.
Prions attach themselves to normal proteins and force them to do ‘protein folding’. Over time they slowly reach the brain, where the exponential growth of misfolded proteins eventually makes the gray matter look like a sponge as it has holes throughout it. That is called TSE - transmissible spongiform encephalopathies and this condition is invariably fatal.

Prions are smaller than the smallest-known virus and as opposed to viruses they can survive in tissue, long after the death of hosts. They appear to be almost indestructible (they are highly resistant to UV, ionizing radiation and formaldehyde) and can contaminate pastures, animal feed, feeding equipment, medical tools, and blood. Prions can also cross species barrier and incubate for decades, and probably their strongest advantage is that they produce no immune reaction. Of course in the current form, prions seem less relevant for our aims as the diseases they cause progress very slowly. However, if these mechanisms can be accelerated, then prions, being incurable and 100% fatal, are an interesting option to study.

Another modern feature which is only starting to take effect, and would probably cause an enormous impact in the near future, is climate change.
Due to milder and shorter winters, disease-carrying insects such as ticks, snails, and mosquitoes, are living longer, eating more, reproduce faster and expand their hunting grounds (each probably wouldn’t have a global effect, but since as earlier mentioned, the desirable way of action is using several different pathogens, in several different ways, this might be a very significant factor).

According to a paper published in the Lancet recently, the early part of the 21st century has seen an unprecedented change in the status of vector-borne disease in Europe. West Nile virus for example, which its vector is a mosquito, has already been confirmed in parts of Eastern Europe, and tick-borne diseases such as Lyme disease continue to increase.

These changes also occur due to increased globalization, with intercontinental flights and air transport creating new opportunities for invasive vectors and pathogens. However, climatic changes play a major role and are forecasted to play an even greater one in the near future.

Climate change can spread environmental features which are usually typical of tropical climates, into what were once temperate climate regions.
Moreover, climate change tends to dry out landscapes or flood them; either extreme create ideal conditions for new viral and bacterial outbreaks in the area.

Climate change does not only affect current pathogens, it may also cause the reemergence of old ones which were trapped in Arctic ice for instance. Some of which may have not circulated in the air since before humans were around to encounter them, meaning, they are probably unknown to their immune systems.
The Arctic also stores pathogens from more recent times. In Alaska, researchers have discovered remnants of the 1918 flu. Some scientists estimate that smallpox is trapped in Siberian ice. And in 2016, an anthrax outbreak in remote regions of Siberia is thought to have resulted from thawing carcass.

But more than any of these factors, of which some are unique to our times and some have been intensified in our times, what should encourage us all is that neither of the pathogens that caused the major pandemics is a relevant model for our mission. We don’t think there is a relevant one yet, and maybe there would never be one single pathogen which is relevant. Maybe only the use of several novel pathogens which combine relevant traits from existing pathogens can overcome humans’ natural and technological defenses. We have elaborated about this issue in the Pathogens and Biotechnology text which is a very important text for you to read.
Past pandemics are not indicators of the probability of annihilating the human race, since the pathogens causing past pandemics are not relevant models, and since the environmental conditions have significantly changed.
Obviously it is very intuitive and unavoidable, but it’s incorrect to merely review past pandemics and current pathogens. What we must focus on is not existing pathogens and their traits, but desirable traits of pathogens and how to combine and maximize them. Pathogens hold great possibilities and with today’s technology they could even be improved to hold the combined advantages of several pathogens, by genetic engineering.

All the pandemics were spontaneous and random outbreaks or at least unpremeditated outbreaks, of pathogens with nonobligatory disadvantages that a guiding hand with modern technology and preplanning can overcome, and therefore, a premeditated pandemic result will be completely different than the ones that occurred so far.
Even without engineering, historic pandemics were very hard to stop. The Spanish flu for example killed 50 -100 million people in just one year and spread all over the world. The Black Death pandemic in Europe was started by the Tartar army which tossed corpses infected with plague to the city of Crimea that was under siege, as a biological weapon. The result was the spread of the pandemic to all of Europe and the death of one third to two thirds of the continent’s population.
In this case, (what is widely thought to be) plague was used as a biological weapon but obviously no biological or genetic manipulations were made over the pathogen and the disease was never intended to spread further. The Tartar army only wanted to subdue the city of Crimea but caused the spread of one of the severest pandemics in the history of Europe.

Pathogens, as efficient as they are in their natural version, hold a much greater and wider potential. It is known that for decades, military facilities in different parts of the world created and manufactured "weaponized" versions of just about all the notorious pathogens known to humanity and we have no reason to believe it doesn’t continue today.
In the words of C.J. Peters, an infectious diseases expert that for the last 30 years worked for the U.S. Army and the Center for Disease Control: "all the steps needed to use certain viruses and bacteria as weapons of mass destruction have been carefully evaluated and found to be workable".
He also said referring to the 6 "Category A bioterrorism agents" (anthrax, smallpox, plague, botulism, tularemia and viral hemorrhagic fevers, including among others the Ebola and Marburg virus) "Every one of these agents has been weaponized by the U.S. or the Soviets or both. Each one of them is known to have been aerosolized, and each has a high morbidity rate and mortality rate."

As a part of the infamous arms race during the cold war both the US and the Soviet Union armies have been conducting extensive research on several pathogens with a potential to be used as biological weapons. During this era, the US accumulated plague for its arsenal but feared to use it, partly due to the acknowledgement they won't be able to control its spread once it is out. We don’t have these boundaries, because we are not trying to infect only a specific part of the human population.

Both the US and the Soviet Union (especially the latter) developed means of weaponizing pneumonic plague. This type of plague is a rapidly fatal disease (nearly 100% fatality rate if not treated within 24 hours of onset of symptoms), highly contagious and airborne (can spread from person to person through the air).
Experiments by the Soviet Union included various delivery methods, vacuum drying, developing strains resistant to antibiotics, combining the bacterium with other diseases (such as diphtheria), and other genetic engineering alterations. Scientists who worked in USSR bio-weapons programs have stated that the Soviet effort was formidable and that large stocks of weaponized plague bacteria were produced.

The CDC wrote: "Why are we concerned about pneumonic plague as a bioweapon? Yersinia pestis used in an aerosol attack could cause cases of the pneumonic form of plague... Because of the delay between being exposed to the bacteria and becoming sick, people could travel over a large area before becoming contagious and possibly infecting others. Controlling the disease would then be more difficult.
A bioweapon carrying Y. pestis is possible because the bacterium occurs in nature and could be isolated and grown in quantity in a laboratory
"

Based on the potential to cause widespread illness and death, Hemorrhagic Fevers Viruses (HFVs) are another category A bioweapon agents according to the CDC classifications. They are considered fearful since there are limited strategies either to prevent or treat these infections. All four known Ebola strains have displayed the ability to spread through airborne particles (aerosols) under research conditions, and there are evidences outside of the labs as well. During the Zaire Ebola outbreak, the New York Times wrote referring to a natural mutation of the virus: "it is not hard to imagine an outbreak that could threaten the globe. A modest genetic change might enable Ebola to spread rapidly through the air and infected travelers could spread the virus widely before anyone realized they were sick." According to scientists from the former Soviet Union, the lethal Marburg virus, Ebola’s closest relative, was made airborne as well.

Smallpox was the prime candidate to be weaponized, especially past 1977. Intensive genetic engineering work was done upon the most potent natural strains (like the India and Bangladesh strains that killed close to 50% of the infected humans).
Biowarfare experts believe that strains far more lethal than natural forms were developed by Soviet scientists. The India-1smallpox for example reached 90% fatality rate among non-vaccinated humans, who are the vast majority of the US population today.

Merely improving the pathogen’s ability to travel by air and efficiently disseminate in tiny aerosol droplets is considered a crucial leap. But much more than that was already achieved. The most interesting genetic engineering project involved combining the smallpox virus with other pathogens. Among those was the alleged merge of smallpox and Ebola to produce a hemorrhagic form of smallpox with a case fatality rate of 100%.
The medical journals that published the Soviet researches led to the conclusion that the genetic combination of these two pathogens that before was dismissed as a myth, was successful.

So even the one aspect that humanity undoubtedly improved throughout history - biotechnology, is actually a two-edged sword. With biological engineering, the pathogen traits can be changed to fit our needs.

Throughout history, pandemics and epidemics have wiped out entire populations and significantly reduced many others. Pathogens are responsible for more human deaths than any other cause. Neither one have wiped out the entire world’s population obviously, but when taking into consideration the state of affairs during the major pandemics from all aspects, there is no doubt that despite their final outcome, they hold great potential.
Biodefense experts know, based on prior record and trends of the future, how severely dangerous pathogens are. The censored publication "Nonproliferation Issues for Weapons of Mass Destruction", by Mark Prelas, Michael Peck and Marcel Dekker (Sep. 2004) summed it up –"Unlike technologies of the past, which did not possess the capability, biotechnology does have the capability of destroying mankind."

The wave off of the biological path by throwing an "argument" like “the human race will always find ways to overcome anything…”, is ungrounded in the better case, and a superficial evasion in the worse. Past pandemics don’t serve as an indication for this, since humanity had never faced a pathogen which was tailor-made to annihilate it. No pathogen ever had the following combination of properties – being highly lethal, having a long non symptomatic contagious period so it has enough time to spread itself before killing its hosts, having reservoirs other than humans so it is much harder to eradicate, being airborne as well as vector borne, and with as little symptoms as possible so it would be hard to detect. A pathogen of this sort was the stuff of fantasy up until several years ago. Today it sounds like a very complicated and very unlikely science, but not science fiction.
Biotechnology, particularly genetically engineered pathogens, will be more attractive to individuals and groups because of the high degree of ease, expertise, low costs, and widespread information.
The developments in biological sciences indicate there is an abundance of possibilities regarding the study of microorganisms and its applicability in creating new biological agents with desirable traits.
Our hope is that more and more activists would think that although it is extremely complex, the suffering abolition movement’s call for action is not impossible. And if the chance to stop the immense suffering humans cause is not technically impossible, exploring this possibility is a moral imperative.