By the time you finish with this book, you may come to the conclusion that the US is just too dang big for its own good. And it's not just government. There are just so many tentacles. No way that the right hand can know what the left hand is doing.
It's the early 2000s. Consider:
Laura Glass - she is the middle school aged daughter of Dr. Bob Glass. He is a scientist at the Sandia National Labs in New Mexico. He models how issues spread. Like how the failure of a bank in NY might spread across the country. His computer screen is a mix of red and green dots in motion. When a red dot touches a green dot, it turns red. When your dad models obscure events, a middle school girl might not understand it all, but it's interesting. Especially when her history class is studying the Black Death. She asks if his modeling thingy might explain the spread of a disease. Sounds like a unique topic for the upcoming school science fair.
Dr. Charity Dean recently finished her residency in internal medicine and got appointed to be Santa Barbara County Health Officer mostly because of her interest in communicable diseases. One of the early cases dropped on her desk was a woman admitted to the ICU with TB in her brain. Got to track this beast down. The County has a history of TB cases and this one is bizarre. Where did the patient contract the disease and what will she have to do to shut it down. Now. And damn be anyone who tries to get in her way.
2005. In his parent's basement in Xenia, OH, Dr. Rajeev Venkayya wrote the first draft of just how the US should respond to a viral pandemic. President Bush has just finished reading a book about the 1918 flu and didn't want to have a repeat on his watch. Rajeev had scored a White House Fellowship. Bush called for a meeting. Being an MD in the White House got him invited. After the meeting, Rajeev went home to Ohio to put fingers to keyboard. He was hoping it wouldn't just be stuffed in a folder somewhere.
Dr. Richard Hatchett, an oncologist by training, was one of the thousands of physicians who answered the call on Sept 11, 2001. The chaotic process of getting MDs on the ground to help led Hatchett to pen a letter the the Alfred P. Sloan Foundation asking the Foundation suits to corner everyone with political clout to push for a national medical reserve corp. The letter worked it's way up the proverbial chain and Hatchett gets a call from the VPs office. Yeah, right. VP of what? Oh, THAT VP. He gets connected with Rajeev. They put out the call across the cabinet posts (cuz that's what the White House does) for people who 'think outside the box.' Pretty soon, that's what they had. All career government insiders . . . except for one. The guy from the Dept of Veteran's Affairs . . .
Carter Mechar was an MD in the Atlanta VAMC. Intensive care specialist. Looked more like a latter day hippie. Unconcerned with recognition and couldn't give a damn about what others thought of him. He just likes to solve problems. Look at data and saw what others failed to see. Like, why did the Charleston VAMC have way too many colon cancer patients? Carter is part of the team looking into the problem. The team looked high and low. Nothing. Carter said let's go back to the beginning. Upon reaching a certain age, the Charleston computers would spit out a mailing of stool sampling kits. You know how they work. Get a sample, stick it in the pre-paid envelope, mail it back. But, the numbers didn't add up. If 100 were sent out, why were only a small fraction returned? Carter went to where incoming mail is processed. A bag of mail is dumped on the counter. In it are a ton of 'insufficient postage' items returned to the VAMC. For the want of a stamp, veteran's with positive tests were being missed. Once the postage issue was fixed, the rates of colon cancer settled back to the expected. Before long, Hatchett and Mechar would revise Rajeev's first draft into a document that, had it been acted upon, might've save thousands of lives.
Dr. Joe DeRisi runs a unique lab at UCSF. During his postdoc at Stanford, he put the finishing touches on an analyzer that can map out the genome of cells, specifically for viruses, in hours and not the weeks that commercial labs required. He acquired a sample of this new virus leaking out of China that had found its way into the US and had its full genome as promised, in hours. Sensing the start of something big, he gathered every capable science-type at the university and set up a lab for mass screenings due to come. Told all the county health officers in California. Sent out millions of the test tubes. But the samples weren't flooding in. Turns out the test kits supplied to him were lacking the swab sticks. A venture capitalists heard of the problem, found a supplier, and sent them DeRisi. What he got was Q-tips. Not long enough. Scratch that. DeRisi went to the manufacturers. Problem was the biggest was in China and most all trade with China had been cut off.
Over time, this divergent group of interested scientist crossed paths. Glass's model, Dean's success with the TB outbreak, Hatchett and Mechar cross paths. Based on modeling, history of the 1918 flu, knowing how the virus spreads, they realize the same conclusion to how to stop the virus in its tracks: social distance should be the #1 point of attack followed by the development of a vaccine. In 1918, that's why St. Louis had a fraction of the deaths that Philadelphia had. That's why Japan was being more successful at slowing the spread of covid. Other countries, too.
These aren't the only one scratching and clawing at the virus. Mechar is invited to speak to the 'Jasons'. An 'anonymous' collection of men in uniform whose name badges all said 'Jason.' Charity Dean is invited to sit in on a zoom call with a bunch of nameless faces that called themselves the Wolverines (from the movie Red Dawn). The Wolverines grow in number. Not able to keep her comments to herself, she blurts out a condemnation of the actions, or lack thereof. One of the nameless faces on the call speaks up. Asks Charity if she's speak to his boss (who turns out to be a Cabinet secretary).
Around the world, you know who wasn't doing so well. The US. And the CDC seemed to be more obstructionist than helpful; 'You can't do that. There's no published data.' No shit Sherlock. It's happening right now. People are needlessly dying and the CDC is only interested in what's published. Charity Dean says that the CDC is mis-named. if the name reflected with they did best, it would be named the Centers for Disease Reporting and Monitoring because when it came to 'Control', Atlanta had no clue.
You don't have to be in the sciences, a policy wonk, or a big data modeler. You only need to be a concerned citizen. The Premonition presents the evolution of the US response to Covid-19, or lack of response. If you think that this is a condemnation of the Trump administration, you'd be wrong because every adminstration dating back 20ish years can shoulder blame.
You may not have heard of Michael Lewis, but I'll bet you know his work. He wrote the source material for Moneyball, The Blind Side, and The Big Short movies (and half dozen other non-fiction books). His work is apolitical and his research digs far deeper than any talking head on TV who recounts US successes and failures in this pandemic. As one who has done some writing, I am impressed with how Lewis can put arcane details into a narrative that is as riveting as anything written by an accomplished novelist. While reading this 2021 copyright book now is a bit behind the curve, The Premonition should be required reading in every MPH program in the country. It should be on the bookshelf of every public health officer in the US. And for God's sake, the issues it raises should be required for everyone associated with the country's public health initiative.
We continue to hear about Heroes of the Pandemic, but have you ever heard the names Glass, Dean, Hatchett, Mechar, DeRisi? Probably not. They are real heroes. Certainly not the CDC. And certainly not the medical-industrial complex that did what they do best in all this - they put profits before people.
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