I love reading about infectious diseases, I really do. And I love reading about the history of public health, particularly in relation to infectious diseases and pandemics. But was it wise to read a book about pandemics, and the weaknesses in our public health infrastructure, at this particular moment in time? Perhaps not!
It’s impossible to review this book without acknowledging the very weird time we are in, and the fact that Sonia Shah, like so many other infectious disease journalists and experts around the globe, predicted this situation. It was creepy, really, to read words that were published in early 2016, and see how accurately they depict our current reality. Consider this quote: “When pandemics unfold, it’s not just because peculiarly aggressive pathogens have exploited passively oblivious victims or because we’ve inadvertently provided them with ample transmission opportunities. It’s also because our deeply rooted, highly nuanced capacity for cooperative action failed. In a general sense, this happens when sufficient numbers of individuals choose to pursue their own private interests rather than public ones.”
How did Shah manage to predict our current predicament? Because it’s happened so many times before, as Shah illustrates with an in-depth look at cholera. Time and time again, people with power have chosen that power, and the money that comes with it, over human lives, and allowed diseases to spread far beyond what they might’ve if we’d responded sooner. Throughout history, infectious disease has never been the same kind of problem for the rich that it is for the poor–the rich have access to clean to water, safer food sources, more space, better health care, and numerous ways to insulate themselves from the rest of us. The disparities we are now seeing with COVID-19–things like asymptomatic celebrities somehow obtaining tests, or people of color being more likely to have adverse outcomes–are examples of this, and you could find their equivalents if you looked back at any pandemic in human history.
So if it’s all happened before, how do we stop it from happening again? As scary and depressing as Pandemic is, Shah did have some words of encouragement at the end. For one thing, we are now living in an age of science, where we can study and develop an understanding of disease. We can understand the basics of how COVID-19 came about and how it spread, unlike our ancestors in the 19th century struggling to understand cholera outbreaks even while they kept drinking dirty water (Pandemic has the distinction of being the only book I’ve ever read to use the word “excreta,” more than once, more than twice, more than I could count on all my fingers and toes, to the point where I had to stop eating snacks while reading it).
I recommend this book, absolutely, and think it’s an important read in order to understand how we got to where we are with COVID-19–but I wouldn’t blame anybody who decided to read something a little lighter right now, instead.