The Scotsman splashed on its front page earlier this week the news that Scotland spent more than 1 million a week protecting us from what turned out to be a mild influenza no worse than winter flu. Did we overreact?
The same questions are being asked, even more forcefully, in relation to the ongoing chaos, disruption and substantial cost of closing UK airspace. Now the planes are back in the air, the recrimination phase is in full flow. Did we overreact?
I must declare an interest. I spent some time in the Scottish Resilience Unit during the swine flu outbreak. I was mightily impressed by the quiet efficiency, rigour and dedication of the people working there: conference-calling Whitehall from a gloomy bunker, wondering where to source additional morgue space for the numbers of dead expected, working round the clock, keeping calm and carrying on. It is the resilience of staff that is most tested in these scenarios, and least considered in the aftermath. And it was already clear in the early stages of the outbreak that the response, the exhausting human effort, was way out of proportion to what was actually occurring on the ground.
What is interesting about the swine flu outbreak – and it has parallels in the volcano episode – is this was a crisis foretold. Ever since the avian flu scare of 2006, there has been a co-ordinated international effort, led by the World Health Organisation (WHO), to be prepared. The Scottish Government's 2007 Pandemic Flu Plan runs to more than 100 pages. Actions and stages are triggered ultimately by decisions taken by the WHO in Geneva. It was the WHO that declared in June 2009 the outbreak had reached "level six" and officially become a "pandemic".
But the pandemic definition contained no reference to severity. Level six is triggered when human-to-human transmission of a virus leads to community level outbreaks in at least two WHO regions. The conditions had been met – in a technical sense.
Our planning proved inflexible. International co-ordination was obviously required to contain the outbreak – viruses do not respect borders. But co-ordinating de-escalation proved very difficult, while the lead agency, taking a technical and a global view, stayed on maximum alert. In fact, we are still at WHO level six today.
There has been something of the same dynamic in the volcano episode: a clear need for European co-ordination; an initial emergency response based on existing regulations, subsequently revised downwards and relaxed in response to new evidence.
But de-escalation happened faster in this case, because there was still local autonomy in the system. The ash cloud was visible, unlike the virus. So it was possible to sanction different regimes for different parts of Europe. Experimentation was possible. The Civil Aviation Authority called in engine experts to consider whether regulations had been drawn too tightly. The commercial airlines did test flights, gathered data and put both commercial pressure and evidence before European transport ministers.
By contrast, the response to swine flu lacked the checks and balances of a differentiated, modulated response. No authority was allowed to depart from the party line. No experimentation was possible. A top-down approach ran all the way from Geneva to Inverness. People on the front line, most able to see what they were really dealing with, could not get their voices heard.
Meanwhile, the commercial interest, if there was one, was set to make money out of the crisis. This was a bonanza for the vaccine manufacturers. US health officials joked from the start that the vaccination programme was clearly part of the fiscal stimulus package. Huge stocks remain unused. And the health committee of the Council of Europe has launched an inquiry into Big Pharma's relationship with the WHO and its possible role in "stoking up panic".
So what are the lessons to be learned from this repeating pattern of planning, overreaction, de-escalation and subsequent recrimination?
The first is that we should not be too hard on ourselves. Crisis management experts will tell you the correct response to potential danger is to overreact. Call the ambulance, evacuate the building, close down the system: because it is better to de-escalate than react too late.
But the second is that we need to be better prepared for de-escalation. It is not generally written into emergency plans. Those plans need to leave room for differentiation and diversity in response, a degree of autonomy for front-line professionals and a mindset at the centre open to evidence that does not support the dominant view.
There is only one picture in the Pandemic Flu Plan. It shows the "typical" trajectory of a pandemic outbreak, with slowly escalating numbers leading to a "two-week peak". Officials at all levels spent far too long waiting for the data to fit the pattern, rather than acknowledging that this outbreak might be of a very different nature.
Thirdly, we need to question whether this whole expensive apparatus of risk management and emergency planning is sustainable in an uncertain, tightly coupled world where the sky is dark with "black swans" (high-impact, low-predictability events).
Former Time foreign editor Joshua Cooper Ramo rightly concludes that "much of what we face cannot be deterred or prevented".
A move from exhaustive risk management to general resilience is the next significant shift we need to make. It would emphasise things, such as local capacity, general levels of health and education, a good transport infrastructure, adaptability and openness to new ideas, psychological literacy and the ability to manage anxiety in the face of overwhelm. These are investments, not costs. They are valuable, 21st-century attributes in any society.
As we are coming to realise, planning for everything is a costly game, and bound to fail.
Graham Leicester is director of the International Futures Forum.