I have noted numerous times how inept Public Health has been in handling the Covid-19 pandemic and the many mistakes that they made. But I was not able to explain in more than general terms why there were so many errors and what was wrong with the system. I have just finished reading an incredible book which explains a lot of this. It documents the many things that happened behind the scenes in the pandemic in the U.S. It tells the stories of many unsung heroes who really made a difference in overcoming the shortcomings of Public Health.
The book is The Premonition by Michael Lewis, published in May 2021. Here are a few of the surprising things that Lewis explained.
The bungled response in the US to the pandemic was not due to Donald Trump. There were many more failures in the system than all the outlandish statements and directives from Trump. Chief among them was the CDC. In many cases the CDC did not act when it should have and in some cases actually hindered some people in the public health system who were trying to contain epidemics, not just for Covid-19 but also earlier public health outbreaks.
The other surprising thing is that George W. Bush was the one who first developed a pandemic plan for the U.S. In 2005 someone gave him a book called The Great Influenza about the 1918 pandemic. There was a document from the Department of Health that laid out pandemic plans to speed up the production of vaccines and stockpile antiviral drugs. Bush said “This is bullshit. We need a whole society plan.” The disaster of 9/11 was still fresh in his mind and so he created a task force to create a comprehensive strategy for dealing with a pandemic.
The task force was interested in computational models that could predict pandemic spread. There were some academic models available but they were complicated, unwieldy and slow. Through an unusual sequence of events, they came across a usable model that had been developed by a 13 year old girl for a science fair and later refined by her father who was a researcher at Sandia National Labs.
Among all the incredible individuals and stories that Lewis uncovered, one person more than any other could be considered the hero. Charity Dean was a public health nurse working in California at the county level. She had a knack for seeing public health risks and had made some bold decisions to contain several infectious disease outbreaks, such as meningitis and tuberculosis. She was noticed and promoted to assistant director of the California Department of Public Health in 2018.
When she saw the reports coming out of Wuhan in December and January 2020, she did some research and became very concerned. But when she tried to inform her boss, she was told not to use the word pandemic because it might alarm people. In the absence of direction from either the Whie House or the CDC, she continued to try to press her case but she was barred from many meetings. Eventually, at the risk of being fired, she intruded on some meetings and her analysis and concerns eventually reached Governor Gavin Newsom. It was her interventions more than anything else that led California to issue a stay-at-home order in March 2020. This was the first state to take such action and it influenced many other states to do the same.
In this short excerpt from an interview, Lewis describes what he wanted to accomplish with this book.
In a more extensive interview Lewis describes the ‘ignored characters’ of the pandemic and why their premonitions were pushed aside.
Here is a more complete book review of The Premonition.
But I don’t think there is any substitute for reading the full book. Lewis is an incredible researcher and writer and there are many fascinating things that are not covered in any interview or reviews. Several previous books by Lewis have been made into blockbuster films.
On the back cover of The Premonition there is this quote from a book review.
I cannot imagine higher praise for an author than this. If Lewis wrote a history of the stapler, I would read it too.
