I Fought The Pandemic And The Pandemic Won

Title: The Premonition

Rating: 4 Stars

When history looks back, it’ll be one of the great mysteries. Before COVID hit, countries were ranked in order of pandemic preparedness. The US was ranked number one. Given the size and scope of our federal government and the fact that the US, by far, has the most expensive health care system in the world, this ranking seemed to be a no-brainer. However, when COVID hit, even though the US has just five percent of the world’s population, it ended up having twenty percent of the deaths. So many other countries with so much fewer resources did so much better. What went wrong?

Lewis’ book doesn’t so much answer the question but has profiles of those that desperately wanted to make a difference but were thwarted by ego, confusion, denial, and bureaucratic malaise.

The book is broken up into three parts. The first part takes place in the years before COVID. Several people saw the SARS pandemic that was centered in Asia and were spurred to action. For all of the justifiable grief that his presidency has incurred, the pandemic plan starts with George W Bush. During the summer of 2006, President Bush read John Barry’s The Great Influenza. This book is a history of the 1918 Spanish Influenza. Shocked at the scale of the carnage, Bush demanded to see the federal government’s pandemic plan. When presented with it, Bush called it “Bullshit”.

A White House team was quickly formed to update the document. Frustrated by the attempts to create a strategy by committee, its leader, Rajeev Venkayya, basically sat down one Friday night and wrote a new one over a span of six hours. This document was immediately used by Bush to justify a seven billion dollar program. Hence, John Barry’s book became known as the seven billion dollar book.

It’s interesting that even back then the importance of closing schools was understood. The scale of the public school system is pretty amazing. There’s something like 70,000 public transportation buses in the country. Compare that to the fact that there are 500,000 school buses. There are 50,000,000 children in public education, half of whom take a bus. Doing any kind of social distancing without taking this into consideration seems foolish.

Can I just take a moment here to remark how unbelievable it is that a Republican President saw a serious gap in planning and thought that the federal government had a role to play in plugging it? We’re talking George W Bush here, a man not exactly known for his big government liberal instincts. The fact that I find this astonishing shows how far the Republican party has strayed from the path of common sense government that it once trod.

The second part of the book concerns the time immediately before the COVID outbreak is widely noticed in the US. The third part are the desperate measures that some people took to control the contagion in the face of both state and federal government indifference.

First of all, let’s talk about the villains. The Center for Disease Control (CDC) does not come out looking good here. By the time 2020 rolls around, they are painted as academics just interested in publishing papers. They refuse to make any decision without data. The whole point of pandemics, especially those featuring a disease that has a long latency period before showing symptoms, is that they move so fast and so invisibly that by the time that you have data it is way too late. The CDC had this world class reputation as being the source for all diseases, but when the time came for them to move, they proved to be a Potemkin village of pandemic leadership.

The federal government takes a fair amount of blame. Even though a pandemic plan had been created way back in 2006, there was no impetus to implement it. During the Trump administration, the National Security Council pivoted to focus only on adversarial threats. They literally fired the people that were in charge of identifying and managing pandemic threats. The CDC was reluctant to declare the COVID a pandemic, not only because of a lack of data, but also to avoid infuriating President Trump.

Private companies also have their share of blame. Slow moving, bureaucratic, and driven by profit motive, they were slow to ramp up affordable testing. Just in time supply chains worked just perfectly until the chains were slightly disrupted, at which point they nearly stopped working completely. During the time of panic, fraud took place. Desperately searching for medical swabs to perform tests, suppliers instead provided Q-Tips and eyelash brushes.

Into this mess were a small number of people who called themselves the Wolverines (after the rebel teenagers in the film Red Dawn). Some of these men, like Richard Hatchett and Carter Mecher, were part of the original team that help build the federal pandemic plan during the W Bush administration. Bob Glass got into pandemic modeling as a result of one of his daughter’s school science projects. Charity Dean was a California county public health director that insisted on practical, hands-on approaches to health crises.

The Wolverines were not a formal team. They’d exchange e-mail and would get together on telecons to discuss what was going on. Over time, more and more people joined the team. Most of the joinees wouldn’t even talk. Anthony Fauci was one of the listeners. Through this completely ad hoc committee, some important decisions and directions were established.

Despite the best efforts of these people, many mistakes were made. The decision to close was made much too late. By the time that decision was made, COVID had already spread widely throughout the country. Testing was too slow to ramp up, meaning that either COVID was missed if the patient was asymptomatic or vital hospital beds were wasted on those that just had the flu.

Despite the fact that the federal government has this reputation as being a monolith, in fact community health is managed by local public health officials. Unfortunately, many times, these officials are retired doctors simply looking for a sinecure in their sunset years.

All of these factors, plus others, meant that, by the year 2023, over 1.1 million Americans had died of COVID.

In my Goodreads summary, I called it the Big Short but with doctors and a pandemic. If you enjoyed reading the Big Short, you’ll probably enjoy this as well. As in both, Lewis profiles a small number of rebels that are fighting against a bureaucratic, monolithic, and generally clueless system.