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4.3 AVERAGE
4.3 AVERAGE
As someone whose health was permanently altered due to COVID-19, this was tough for me to read. I had to take breaks to keep my blood pressure from boiling over with rage at how many badly the ball was dropped by our government. We weren’t ready - and we should have been. Plenty of people tried to ensure we were. (And guess what? We won’t be ready for the next one either, because I’m not sure we learned our lessons.)
Overall, a solid recent history on the attempts to prepare the U.S. for pandemics and the politics involved.
Overall, a solid recent history on the attempts to prepare the U.S. for pandemics and the politics involved.
I had no idea how dysfunctional our government is when it comes to the pandemic response. Thank goodness for the passionate individuals who, despite the government's inaction, made it their mission to combat the virus and, as a result, saved so many lives.
The first half that explores the history and science of pandemics was fascinating, the second half covering the COVID 19 pandemic felt like a repetitive 1 star Yelp review of the CDC
I'm sure so many are in pandemic fatigue and the thought of reading about it may be overwhelming. I felt this way but it was on sale and I've enjoyed other books by Michael Lewis, including Moneyball and The Big Short. The central "characters" in this book are fascinating people who are dedicated to public health and felt that the US would do all the right things if a pandemic were to occur. By the end, Lewis exposes not just the failings of the Trump administration but those at every level of government and in particular health care. While we should have been at the forefront of a pandemic response, setting an example for other countries, the US response created a catastrophe resulting in thousands of unnecessary deaths. It is frightening how politicized the CDC has become and hopefully the World Health Organization will in the future, not wait on the CDC to make recommendations. Lewis describes it as an organization not to be trusted in a battlefield situation as it has become a wait and see, don't upset the president, silo that is riding on a reputation that is no longer deserved. This is a book for everyone...unless you still think the virus was a hoax.
I didn’t actually finish this but for what I made it through it was decent I think I just overlapped with too much of my required course reading right now to get me to finish
While we were busy worrying about catching Covid-19, and wondering about wearing masks (did they really help? why did some people fight the idea so much while others just got on with it?), and cleaning our groceries before putting them away, there were smart people and not-so-smart people working on our national response (or lack thereof) to a pandemic virus the likes of which had not been seen in the US in a century. This is their story.
Eye-opening. I had no idea how incredibly inefficient the US healthcare system is and I doubt this is unique to the US. It amazes me how it takes people fighting tooth and nail to make things happen. I don't think any of these systems have changed since COVID and we are woefully unprepared for the next pandemic.
Holy cow. As a proud holder of a public health degree from one of this country’s finest schools of public health, I was appalled by a lot of what I read here. I know that public health is horribly underfunded, but I’m embarrassed by how little I understood the fractured nature of this utterly broken system. Don’t even get me started on the CDC. My biggest takeaway is that I’m grateful for the behind the scenes people, many of whom are featured in this book, who are able to work around and between those whose political ambitions, hunger for power, capitalist leanings, or cowardice have stood in the way of promoting the public’s health. This should be required reading or at least a very cautionary tale for those who want to do better than the dumpster fire of a situation we are in now.
I liked this book a lot more while I was reading it than I did after I finished it. It felt like a narrative as I was reading it, but there was no ending. Now, of course, the pandemic is still on-going, so clearly the story hasn't ended, but I don't know...it just didn't wrap up for me somehow.
Some of the characters are more clearly delineated than others, and some seem to be entirely skipped over, and there's no real explanation for why, other than maybe some people gave the author more of their time and themselves than others.
I'm glad I read it, but it also made me very uncomfortable. I want to trust our public health institutions. I want to believe that the officials at the CDC have our best interests at heart and in mind. This book strips those comforting illusions away.
Some of the characters are more clearly delineated than others, and some seem to be entirely skipped over, and there's no real explanation for why, other than maybe some people gave the author more of their time and themselves than others.
I'm glad I read it, but it also made me very uncomfortable. I want to trust our public health institutions. I want to believe that the officials at the CDC have our best interests at heart and in mind. This book strips those comforting illusions away.
"A system was groping toward a solution, but the solution required someone in it to be brave, and the system didn’t reward bravery. It was stuck in an infinite loop of first realizing that it was in need of courage and then remembering that courage didn’t pay."
-p226
Human and affecting story of personal intellectual courage and bureaucratic cowardice.
The Center for Disease Control is the villain in this story, as is (seemingly) Sonia Angell, the short-lived Director of the California Department of Health.
A number of fascinating, disparate individuals come together to advise and coordinate big parts of the COVID-19 pandemic. Most of them aren’t officially supposed to be doing so, but they take personal risks to do what they think is right, even if the state or federal government leadership doesn’t want their expertise and boat-rocking.
Some of these people are in local public health, others in academia, there’s a brilliant clinical doctor at a VA (a “redneck epidemiologist”), a few mathematical modelers, brought together by a large heaping of chance. The first half of the book recounts the stories of how each person had formative experiences that led them to their unusual position within the COVID-19 response. One includes a dad helping his daughter with her high school science fair project on pandemics. One includes a no-nonsense public health worker in Santa Barbara county sniffing out the source of a Hepatitis C outbreak when the CDC couldn’t be bothered. And so on. These people were in the shadows and going above and beyond, like Richard Hatchett:
“He was like cheating on his family for pandemic preparedness.”
Lots of fascinating and relevant digressions can be found herein, like the Mann Gulch incident (a lethal fire in 1949 in Montana), which I had never heard of. That is to say, supposed experts approaching a potentially dangerous situation, unaware of its lethality until too late, and once the realization is made that circumstances have changed, there is no turning back.
The California setting is relevant and unique to the story. Private hospitals were contractually obligated to send COVID tests to private labs. So, when an all-volunteer army of grad students built a free testing laboratory in San Francisco over a couple of days, with the ability to quickly process thousands of tests per day, most hospitals declined because of their contractual obligations and continued to laboriously send the tests to Quest Diagnostics or others, despite the latter taking several days as opposed to several hours.
Genomic sequencing was understood to improve contact tracing and inform what to do to isolate superspreaders, but even as of February 2021 less than a fraction of a percent of US cases have been sequenced, by far the least in the developed world. For comparison, the UK has sequenced over 10% of cases and some Scandinavian nations are trying to sequence all cases.
One of the themes, whether intentional or not, is that bureaucrats and experts are often risk-averse in these difficult situations. Lewis writes about an assertive public health physician who was always being frustrated by inaction when she asked for help: “Her model started with two assumptions. One, something was coming. Two, the CDC wouldn’t deal with it.” The narrative celebrates science, modeling, clinical acumen, and narrow expertise, but also cautions us not to cede too much decision-making power to those who aren’t on the front lines.
As D.A. Henderson wrote:
“I have found that there is an order of magnitude difference between bearing the ultimate responsibility for decision-making and being either an advisor or a student of the process. It’s one thing to experience an orgasm or an arrow between your ribs and it’s another thing to read about it.”
-p287
-p226
Human and affecting story of personal intellectual courage and bureaucratic cowardice.
The Center for Disease Control is the villain in this story, as is (seemingly) Sonia Angell, the short-lived Director of the California Department of Health.
A number of fascinating, disparate individuals come together to advise and coordinate big parts of the COVID-19 pandemic. Most of them aren’t officially supposed to be doing so, but they take personal risks to do what they think is right, even if the state or federal government leadership doesn’t want their expertise and boat-rocking.
Some of these people are in local public health, others in academia, there’s a brilliant clinical doctor at a VA (a “redneck epidemiologist”), a few mathematical modelers, brought together by a large heaping of chance. The first half of the book recounts the stories of how each person had formative experiences that led them to their unusual position within the COVID-19 response. One includes a dad helping his daughter with her high school science fair project on pandemics. One includes a no-nonsense public health worker in Santa Barbara county sniffing out the source of a Hepatitis C outbreak when the CDC couldn’t be bothered. And so on. These people were in the shadows and going above and beyond, like Richard Hatchett:
“He was like cheating on his family for pandemic preparedness.”
Lots of fascinating and relevant digressions can be found herein, like the Mann Gulch incident (a lethal fire in 1949 in Montana), which I had never heard of. That is to say, supposed experts approaching a potentially dangerous situation, unaware of its lethality until too late, and once the realization is made that circumstances have changed, there is no turning back.
The California setting is relevant and unique to the story. Private hospitals were contractually obligated to send COVID tests to private labs. So, when an all-volunteer army of grad students built a free testing laboratory in San Francisco over a couple of days, with the ability to quickly process thousands of tests per day, most hospitals declined because of their contractual obligations and continued to laboriously send the tests to Quest Diagnostics or others, despite the latter taking several days as opposed to several hours.
Genomic sequencing was understood to improve contact tracing and inform what to do to isolate superspreaders, but even as of February 2021 less than a fraction of a percent of US cases have been sequenced, by far the least in the developed world. For comparison, the UK has sequenced over 10% of cases and some Scandinavian nations are trying to sequence all cases.
One of the themes, whether intentional or not, is that bureaucrats and experts are often risk-averse in these difficult situations. Lewis writes about an assertive public health physician who was always being frustrated by inaction when she asked for help: “Her model started with two assumptions. One, something was coming. Two, the CDC wouldn’t deal with it.” The narrative celebrates science, modeling, clinical acumen, and narrow expertise, but also cautions us not to cede too much decision-making power to those who aren’t on the front lines.
As D.A. Henderson wrote:
“I have found that there is an order of magnitude difference between bearing the ultimate responsibility for decision-making and being either an advisor or a student of the process. It’s one thing to experience an orgasm or an arrow between your ribs and it’s another thing to read about it.”
-p287