Thursday, November 25, 2021

The Premonition is more relevant than you might think

When it was announced Michael Lewis had a new book out, many of us were quite excited, but when we learned the topic was pandemics we felt it was premature.  BUT don't ever underestimate Michael's ability to find different, but relevant angles to a topic that most others have overlooked.

As usual Michael seems to float around a wide range of perspectives.  A short blog can only hint at various attacks.  Other reviewers might choose a different set of tidbits, but the truth is the topic demands a book to truly understand.  Hopefully your appetite for comprehending the crisis and how we might tackle it better in the future will be whetted.  

 One different perspective came from 13 year old Laura Glass whose father was involved with disaster planning, but not including communicable diseases.  For a science contest in 2003 she developed a model dealing with contagious diseases.  She realized the key driver is social interaction and theoretically it is the young, more socially active people who should get vaccinations before their elders.  Of course we also realized that the elderly were the most vulnerable.

From the 1918 Spanish flu pandemic it was thought not much was learned, but re-examining information it was learned that cities that relaxed social distancing in response to business pressures suffered more than those cities that didn't.  It was important to intervene before the pathogen exploded.  The contrasting examples are Philadelphia and St. Louis.

In 2009 Obama was lucky when he accepted advice from the CDC (Center for Disease Control) which could have gone another way.  Some authorities think he should have shut down the schools, however as one expert pointed out if nothing happens, the drastic steps that made it possible are thought to have been unnecessary inconveniences and eventually forgotten.  More recently, analysis said a factor for the Republican victory in Virginia 2021 was that they had closed the schools more than other states and voters especially mothers were very upset over the inconvenience.  

 Religious restrictions hampered understanding of science.  One example was cutting out evolution from schools.  If youngsters cannot be taught to appreciate science they may grow up to be suspicious of expert opinions.

Standard doctor questioning is focused on an individual and is not adequate for learning the path of a communicable disease.

Charity Dean was a public health nurse in California who had strong feelings about pandemics, but had been squelched by her superiors.  Eventually she did rise to play a stronger role.  One of her ideas, "The one shot America had at behaving well and thus saving itself was to remove the feeling that "the government" was imposing restrictions on people and re-instill the idea that people were imposing order on themselves to fight a common enemy."   

Joe DiRisi developed a new chip while at University of California San Francisco that sped up virus testing.  Realizing the SARS virus originated with horseshoe bats, among many other projects he researched pythons and set up a genome bank to track viruses unique to them that might eventually transmit to humans.   Patricia Chan Zukerberg, wife of Mark Zukerberg and a trained pharmacist donated $600 to Joe's research team.

After Jimmy Carter, the CDC director position became a political appointee under Ronald Reagan.  The White House interfered with the CDC whenever it conflicted with the Republican base or their financial supporters.  One example was with AIDS and another was with aspirin research with children.  Politics continued to affect medical research.  When John Bolton picked by Trump to run Homeland Security he ended up firing many staff to focus more on outside forces.  A critical advisor, Tom Bossart was fired after he stated that it was not Ukraine that interfered in 2016 election.  Trump  broke up agencies that should have been able to deal with potential pandemics.  The Mexican border was a a big Trumpian obsession stirring up for public relations, but actually neglected during early stage of pandemic.

In late February 2020 the CDC announced that the disease was inevitably going to spread.  This caused an 1,100 drop in the stock market and upset Trump.  Vice President Pence ordered that no one in the Department of Health and Human Services was allowed to say anything that might alarm the public.  As we all know Trump claimed the pandemic was not a concern. 

Lewis's prior book was "The Fifth Risk".  Barrack Obama had put together a transition team to prepare the incoming Trump administration, but was ignored.  Positions were filled not with experts, but with political appointees.  Research was cut to make room for tax cuts.  Preparations for potential disasters were minimized or ignored.

The dilemma faced by public health officials is that an aggressive early response is required to deal with a pandemic, but if successful afterwards citizens remember only the restrictions.  Politicians fear the resentment voters express.

From the Acknowledgments Michael Lewis has established such a reputation that others suggest people he should talk to.  Some five years ago he was persuaded to talk to Joe DiRisi.  After that talk he looked for an excuse to write about him.  Shortly after Joe joined with others to encourage him to speak with Charity Dean.  To me, Michael is the one looking for the overlooked angles that are relevant. and behind the headlines. 

I was struck watching "Japan Sinks:  People of Hope" (2021) that with a shocking physical calamity one high ranking politician exclaimed how too many people did not realize that the economy is the base of the country.  It was more immediately obvious than with a pandemic as an earthquake crumbled a city and people had to scramble for safety.  Politicians supported by big business will always want to protect the financial interests at least as much as health concerns.

No matter the topic Michael Lewis is sure to open our eyes.  I highly recommend his books.

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