A look at some more of the popular science books which have gone viral during the coronavirus pandemic.
Since we compiled our first Encyclopaedia Pandemica reading list before the Covid-19 lockdown, there has been a major outbreak of pandemic-related books, some new, some rehashed and some trawled from publishers’ back-catalogues. We’ve had a look at a selection of these and on the surface, a common theme appears to be “how to prepare for the next one”.
Making initial judgements of books by their covers, we started with what look like the more serious “popular science” contributions. Who are the people writing these books, what is their advice and how qualified are they to give it?
Michael Greger: How to Survive a Pandemic (Flatiron Books NY, 2020)
Despite its reassuring title, this is mainly an overview of pandemic literature from the Black Death to Covid-19. In itself that is a monumental achievement, and one we can thank the coronavirus for as Greger worked on it during lockdown; the eBook has 370 pages of text comprehensively covering all aspects of influenza and coronavirus epidemics, backed up with a further 327 pages of references. But like Greger’s 2007 book on Bird Flu, How to Survive a Pandemic can be criticised for being full of doomsday scenarios – mainly concerning intensive poultry farming – while offering little in the way of practical advice.
The audiobook is a bit of a treat, being read by Greger himself; the author is generally preferable to a professional narrator, as you know they are going to pronounce terminology correctly and put emphasis in the right places. Greger is engaging to listen to, with a quirky style of delivery and certainly has nothing of the slow monotone or random inflection of certain professional audiobook narrators. But he does keep banging-on about poultry farming.
Examining Greger’s CV a bit more closely, things start compiled from Greger’s 3500-plus references, there are a few particularly interesting sections. There is a pandemic-planning checklist culled from an archived US Government web-page, and several informative diagrams from sources including the WHO. However, where major questions about pandemics are tackled, the answer usually boils down to “we don’t know yet”. But there is one question with a very definite response: "How can we stop the emergence of pandemic viruses in the first place? Greger’s answer – which is explained over the last 40 pages of the book - is very simple: Get rid of chicken farms.
Within the factual parts of How to Survive a Pandemic, compiled from Greger’s 3500-plus references, there are a few particularly interesting sections. There is a pandemic-planning checklist culled from an archived US Government web-page, and several informative diagrams from sources including the WHO. However, where major questions about pandemics are tackled, the answer usually boils down to “we don’t know yet”. But there is one question with a very definite response: "How can we stop the emergence of pandemic viruses in the first place?" Greger’s answer – which is explained over the last 40 pages of the book - is very simple: Get rid of chicken farms.
Ali S. Khan (with William Patrick): The Next Pandemic - On the Front Lines Against Humankind's Gravest Dangers (PublicAffairs USA, 2016)
Now here’s someone eminently qualified to be writing this book. Dr. Ali Khan is a big hitter at top Federal level in the USA. He is currently Dean of the College of Public Health at the University of Nebraska Medical Center and an Assistant Surgeon General. Prior to this he spent 20 years at the USA’s Centers for Disease Control and Prevention (CDC), including five as Director of their Office of Public Health Preparedness and Response. William Patrick – described as an editor, book doctor, and ghost-writer, as well as having written a two thrillers about biological threats – is clearly here to give overall shape to these memoirs, and I suspect may be responsible for the endless stream of literary/popular cultural references. In the first chapter alone he namechecks Indiana Jones, Downton Abbey, Raymond Chandler, John le Carré, James Bond, Dr. Zhivago, Game of Thrones and the movie Airplane!
As the narrative unfolds, we accompany Dr. Khan on a series of global adventures from Sierra Leone to Singapore – and closer to home – as he does his job as a detective for deadly diseases, piecing together the clues and cornering the guilty microbe. This is a fascinating and extremely readable account, giving a unique insight not only into the work of Dr. Ali and his colleagues as they respond to public health emergencies, but also the wider effects of public panic and government intervention.
In the final chapter Dr.Ali examines some of the factors that have contributed to increased infection risk – our high population density, proximity to animals, over-use of antibiotics and social inequality, as well as laboratory accidents and bioterrorism. He goes on to outline some advice to governments and the WHO and predicts how infectious diseases will continue to spread because of climate change. He says we should also be worried about SARS and MERS – and since these are both caused by coronaviruses, that turned out to be a very pertinent prediction.
Michael T Osterholm & Mark Olshaker: Deadliest Enemy - Our War Against Killer Germs (Little, Brown and Company NY, 2017)
Not surprisingly, Michael Osterholm has had a high media profile recently; the Covid-19 pandemic has made this top-level public health professional very much in demand. He is currently Director of the Center for Infectious Disease Research and Policy at the University of Minnesota, and has a CV in public health and infectious diseases which makes you wonder what hasn’t he done. As with Khan and Patrick, Osterholm had formed a writing dream-team with Mark Olshaker – best known for collaborating with FBI agent John E. Douglas in writing books about criminal and investigative psychology. Critically acclaimed at the time, Deadliest Enemy was noted particularly for drawing attention to goverments’ lack of preparedness for the next pandemic – another instance where comments have been made about the authors’ prescience in the light of Covid-19.
The early chapters of Deadliest Enemy mainly cover case studies detailing Osterholm’s involvement in investigations of unfolding outbreaks of diseases such as AIDS and Toxic-Shock Syndrome. Moving on to our lack of preparedness for pandemics, this is put down in part to what Osterholm calls the “threat matrix”, what you could call our “danger RADAR”. This operates on both a personal, national and global level, leading to disproportionate responses to various potential hazards. For example, we worry about getting on an aircraft but travel daily in motor vehicles which have a much higher accident/death rate. Similarly, the 9/11 attacks which killed 3000 people prompted countless billions of dollars of spending on anti-terror measures by the US government, but they are relatively complacent about preparing for a pandemic which could kill millions. Within his threat matrix, Osterholm subdivides infectious diseases using this hierarchy:
• pathogens of pandemic potential
• pathogens of critical regional importance
• bioterrorism, dual-use research of concern, and gain-of-function research of concern
• endemic diseases
Most usefully, he gives us an agenda with key points to help protect us from these threats. Tackling the lack of a fully effective ‘flu vaccine, tackling antimicrobial resistance and expanding global pandemic preparedness are at the top of his list.
In a scary foretelling of covid-19, Osterholm reminds us that the SARS epidemic of 2003 was caused by a coronavirus which originated in bats, then transmitted to humans via intermediate species sold in a Chinese wet market. Does that sound familiar? He goes on to say that just because SARS was contained, there is nothing to “stop Mother Nature from throwing additional coronaviruses at us.” The first of these was MERS in 2012, again originating in bat populations but this time in the Middle East. As is well known, the Wuhan wet market at the centre of the Covid-19 outbreak was selling live bats for consumption as well as – presumably – the as yet unidentified intermediate species which transmitted the coronavirus to humans. We were warned.
Osterholm’s ongoing series of podcasts on Covid-19 are available here.
Sonia Shah: Pandemic - Tracking Contagions, from Cholera to Ebola and Beyond (Farrar, Straus and Giroux NY, 2016)
Sonia Shah is a prizewinning investigative journalist who writes on topics as diverse as science, politics, global health and human rights. Before you even open Tracking Contagions, you know you’re going to enjoy it. She writes in an easy, colloquial style producing a well balanced synthesis of current scientific thought and personal experience.
Shah has found herself very much in the limelight during the Covid-19 pandemic, and has been openly critical of the Trump administration’s handling of the crisis. Her blog has an impressive collection of interviews and articles – well worth reading your way through.
Shah’s publisher says of Tracking Contagions:
More than three hundred infectious diseases have emerged or re-emerged in new territory during the past fifty years, and ninety percent of epidemiologists expect that one of them will cause a disruptive, deadly pandemic sometime in the next two generations. To reveal how that might happen, Sonia Shah tracks each stage of cholera's dramatic journey from harmless microbe to world-changing pandemic, from its 1817 emergence in the South Asian hinterlands to its rapid dispersal across the nineteenth-century world and its latest beachhead in Haiti. She reports on the pathogens following in cholera's footsteps, from the MRSA bacterium that besieges her own family to the never-before-seen killers emerging from China's wet markets, the surgical wards of New Delhi, the slums of Port-au-Prince, and the suburban backyards of the East Coast. A deep-dive into the convoluted science, strange politics, and checkered history of one of the world's deadliest diseases, Pandemic reveals what the next epidemic might look like--and what we can do to prevent it.
Jonathan D. Quick (with Bronwyn Fryer): The End of Epidemics - The Looming Threat to Humanity and How to Stop It (St. Martin’s Press NY, 2018)
Again, a top professional teams-up with a noted writer: Jonathan Quick is professor of global health at Duke University in North Carolina and has worked in public health since 1978. Yet another “pandemic expert” who is finding himself in demand by the news networks to answer questions about Covid-19. Bronwyn Fryer, her own website tells us, is a “veteran business writer, researcher and editor who collaborates with thought leaders to produce influential books and articles”. Both have impressive CVs, and their alliance produces an almost perfect piece of popular science writing; both informative and compelling. Quick’s immense body of knowledge, illustrated with copious examples, interviews and scenarios, is given Fryer’s deft treatment. Understandably, given the subject matter, there is a fair bit of scaremongering but this is handled without tipping over the edge into over-sensationalism. The only annoying aspect of The End of Epidemics is repetition. Quick tells you what he’s going to say, then says it, then summarises it. Great for academic journals where you may only read the abstracts, but nor really necessary for the general reader.
The book is structured around what Quick calls “The Power of Seven”, a list which – repeated several times – temporarily gives the book the flavour of a self-help manual. He explains: “…we can end epidemics by facing up to them and applying concrete actions I call “The Power of Seven”:
1. ensuring bold leadership at all levels;
2. building resilient health systems;
3. fortifying three lines of defense against disease (prevention, detection, and response);
4. ensuring timely and accurate communication;
5. investing in smart innovation;
6. spending wisely to prevent disease before an epidemic strikes; and
7. mobilizing citizen activism.”
Amidst the chapters where Quick expounds his way through this list, there is plenty that will be familiar to the Covid-19 generation. For example, in one scenario “…an uncontrollable pandemic overwhelms public-health systems and wipes out millions of people in less than a year. Business and industry grind to a halt. Up…a tenth of the country’s global gross domestic product evaporates as fear of infection stifles travel, tourism, trade, financial institutions, employment, and entire supply chains. Children stop attending school. Rumors abound; neighbors scapegoat neighbors.” Fortunately, the effects of Covid-19 haven’t quite gone as far as that, or on to a situation where “millions of unemployed poor, always hit the hardest, resort to theft and violence in an effort to stay alive. People starve, even in the U.S. Those who do survive are left with their lives turned upside down.”
As Covid-19 sufferers recover, there is growing evidence that some are still suffering from symptoms after eight weeks or more, including breathlessness, fever, fatigue and loss of appetite leading to weight loss. Certainly, UK Prime Minister Boris Johnson is still looking extremely tired when we see him at press conferences nearly two months after he was discharged from hospital. With reference to 2003’s coronavirus outbreak, Quick tells us “…people who contracted the SARS virus faced all kinds of chronic problems as a result. One study found that even after recovering from SARS, 88 percent of patients suffered ongoing problems like shortness of breath, muscle pain, and fatigue so debilitating that they could not return to work.”
Quick’s epilogue “Headlines from the Future” includes another summary of the book followed by some science-fictional news items. Particularly pertinent is the report of the the successful tackling of a SARS (ie. coronavirus) outbreak in 2026, “a near-perfect example of how the new global epidemic prevention and response strategy is working.” If only.
Nathan Wolfe: The Viral Storm: The Dawn of a New Pandemic Age (Times Books NY, 2011)
The earliest book of those considered in this post, The Viral Storm is still eminently readable and absorbing. It may not offer any insights into pandemics in general, or Covid-19 in particular, not repeated in later works, but is a worthy addition to the Encyclopaedia Pandemica bookshelf.
Here are a few words from penguin Books, who publish The Viral Storm in the UK:
In The Viral Storm award-winning biologist Nathan Wolfe - known as 'the Indiana Jones of virus hunters' for his work in jungles and rain forests across the world - shows the threat of a global pandemic is greater than we have ever imagined.
The Viral Storm examines how viruses like HIV, swine flu, and bird flu have almost wiped us out in the past - and may do so in the future. It explores why modern life makes us so vulnerable to global pandemics, and what new technologies can do to prevent them. Wolfe's provocative vision may leave you feeling distinctly uncomfortable - but it will reveal exactly what it is we are up against.
Nathan Wolfe is the Lorry I. Lokey Visiting Professor in Human Biology at Stanford University and Director of Global Viral Forecasting, a pandemic early warning system which monitors the spillover of novel infectious agents from animals into humans. Wolfe has been published in or profiled by Nature, Science, The New York Times, The New Yorker, The Economist, Forbes and many others. Wolfe was the recipient of a Fulbright fellowship in 1997 and was awarded the National Institutes of Health (NIH) International Research Scientist Development Award in 1999 and the prestigious NIH Director's Pioneer Award in 2005.