- On the Origin of the Deadliest Pandemic in 100 Years: An Investigation
- Biblioasis (2021)
- The Plague Year: America in the Time of COVID
- Alfred A. Knopf (2021)
- Shutdown: How COVID Shook the World’s Economy
- Viking (2021)
- Inflamed: Deep Medicine and the Anatomy of Injustice
- Farrar, Straus and Giroux (2021)
Two years after the announcement of a novel pneumonia in Wuhan, the flood of books about COVID-19 is just getting started. But a number of writers have exploited lockdowns and good access to the internet by staying home and tracking the pandemic in real time.
Some have tried to explore some specific aspect of COVID-19, like its supposed origins in the labs of the Wuhan Institute of Virology. Others have focused on American politics, or on the pandemic’s economic impact. Very few have stepped back to gain a better perspective on the causes of pandemics in general, and tried to find solutions in prevention, rather than in a technological response.
Elaine Dewar’s On the Origin of the Deadliest Pandemic in 100 Years is well written, superbly researched and produced at high speed under the difficult conditions of the pandemic. But the title itself is wrong: the deadliest pandemic since the “Spanish” flu is HIV-AIDS, which according to the World Health Organization has infected about 80 million people and killed 36 million of them in the past 40 years. By comparison, COVID-19 has infected far more (270 million by mid-December 2021) but killed (so far) far fewer: something over 5 million.
Dewar’s thesis is that China was engaged in dangerous virus research at WIV, was spying on Canada to enhance that research, and Canada in turn was playing dumb about that espionage. Meanwhile, anyone in the West who didn’t buy the lab-leak theory was either a useful idiot serving Chinese interests, or a paid tool of Beijing, or both.
The result is not a useful analysis of the origin of the virus. If it was accidentally leaked from a Chinese lab, knowing that would get us no closer to the origin. An analysis would identify the animal source of SARS-CoV-2, so that we could take steps to prevent it from happening again. By now, it hardly matters: humans are superb vectors, and the next pandemic is likely to come from yet another virus in yet another animal.
Dewar’s book is, however, an excellent whodunit. In a whodunit, the detective names the villain and thereby exonerates the rest of us — even Donald Trump, who insisted on calling it the “China virus.” And once the villain is known, justice will be served and the status quo restored.
The status quo, however, is unlikely ever to be restored — a point most of these writers seem reluctant to face. The pandemic has exposed every weakness in the societies it attacked — including the sincere desire of the rulers of those societies, whether Justin Trudeau or Xi Jinping, to carry on business as usual.
‘I think we’re too late’
Lawrence Wright’s The Plague Year is a vivid history of the American response to the first year of the pandemic. Wright is a novelist, playwright and journalist who won a Pulitzer Prize for his book on the war in Iraq. Like other writers, he settled down for an indefinite lockdown with a good internet connection, formidable online research skills and excellent connections.
Wright began his career as a young reporter covering the Centers for Disease Control and Prevention, and in early 2020 he published a novel describing a pandemic; it was based on extensive research, so he understood what was happening earlier than most. He went back to his sources, who gave him excellent material.
So he can begin his book with an account of how Robert Redfield, then the director of the CDC, learned on New Year’s Eve 2019 about the first 27 cases of “pneumonia of unknown cause” in Wuhan. Redfield got in touch with George Gao, his Chinese opposite number, offering to send experts to help investigate. Gao said the offer should go to Beijing, and Redfield made it, but never got a reply. Early in 2020 Redfield called again, and Gao started to cry. “I think we’re too late. We’re too late.”
Much of Wright’s book is that kind of vivid reportage, making it a superb history of the U.S. in the first year of the pandemic. That makes it also a damning account of the Trump administration’s response. It had inherited a 69-page “playbook” on how to handle a “pathogen of pandemic potential.” Officials showed little interest in that manual, but did run an exercise scenario in which American tourists return from China with a novel influenza.
As Wright says, “The Trump administration’s own exercise was spookily predictive of what was to come, including how chaotically the government would respond.” The exercise foretold shortages of PPE, ventilators and other resources, as well as confusion about who was supposed to be in charge. The administration did nothing to correct these problems.
Wright dramatizes this lapse by showing it through the eyes of Matt Pottinger, a reporter, veteran and Mandarin speaker who somehow ended up in the Trump administration. Pottinger had his own Chinese connections, and a brother who was a doctor, so he understood the threat. When he suggested a travel ban that might buy some time, other Trump aides were appalled: it would ruin the aviation industry and trade. Well, it was already too late, just as the recent travel ban on southern Africa has been after Omicron. Trump liked Pottinger’s idea, but imposed it only on non-Americans coming from China. COVID-19 outflanked North America from Europe.
Pottinger soldiered on, turning up for meetings wearing a mask when no one else did, and when masks were not to be worn, he stopped going.
If Trump had really taken charge, Wright argues, his public health experts might have prepared the country better. Instead, “By his words and his example, the president became not a leader but a saboteur. He ridiculed mask-wearing. He campaigned against taking the pandemic seriously. He subverted his health agencies by installing political operatives who meddle with the science and suppressed the truth.”
Wright says that when Trump announced the appointment of Amy Barrett to the Supreme Court with an event in the White House Rose Garden, the president himself was the superspreader, infecting many of the guests as well as his wife.
The Plague Year concludes with Matt Pottinger’s Jan. 6; he had wanted to resign but had promised to stay on to help the Biden transition team. He witnessed the assault on the Capitol and conferred with a colleague on the National Security Council; the colleague decided to stay on, rather than risk the collapse of council.
Pottinger left for the last time early on the morning of Jan. 7, after Biden and Harris had been named president and vice-president; “With each step away from the White House, he felt a growing sense of rage.”
As powerful as Wright’s narrative is, it is too tightly focused on the U.S. and its elite — of which he is a part. Yes, the American response was crucial, and responsible for the foothold COVID-19 gained that has so far inflicted 50 million cases on its own citizens, as well as 800,000 deaths. The American elite has so far escaped most of those cases and deaths, which have hit working-class Americans, especially people of colour and supporters of Donald Trump.
But like the rest of the world, the Americans have not escaped the economic consequences, whether the windfalls for the rich or the disasters for the poor. Another book, Adam Tooze’s Shutdown, pulls back for a far wider view of the pandemic.
Tooze, a British historian teaching at Columbia University, specializes in economic history. He has written on the economy of Nazi Germany and more recently on the crash of 2008. The pandemic trapped him in New York, but he made the most of it by spending 2020 tracking the economic impact of COVID-19 and taking notes.
Given Tooze’s extensive economic expertise, his shock at the events of early 2020 gives us a sense of how much worse they were than they seemed to most of us at the time. It wasn’t so much a lockdown imposed from outside as a shutdown. People hunkered down on their own, cancelled travel plans, closed their businesses and laid off staff. Investors headed for safety as stock markets fell.
Beijing’s response to the outbreak startled the world with its ferocity. Not only Wuhan but all 60 million people in Hubei province were sealed off, while thousands of doctors and nurses were drafted from the rest of the country to battle the outbreak, while effectively shutting down the second-biggest economy in the world. Investors elsewhere decided that if the Chinese were scared, they should be too.
By March 2020, Tooze writes, “as many as 132 million workers were either temporarily unemployed, displaced or furloughed, which would amount to 30 percent of China’s urban workforce.... Up to that point, it was the worst labour market shock ever experienced by any economy in the world.”
Even so, it wasn’t enough to smother the virus. Since the 1980s, “the market” had made key decisions, not governments. Politicians might at most tweak local policies, but they never challenged the premises of the global economy. “On all sides,” Tooze writes, “February 2020 delivered a staggering demonstration of the collective inability of the global elite to grasp what it would actually mean to govern the deeply globalized and interconnected world they have created.”
Facing an economic collapse greater than the 1930s, the global elite abandoned the whole neoliberal system, which was built on excluding political decisions from interfering with the market. Without such decisions now, the elite was doomed. As Tooze writes, “In the course of the disastrous dot-com crash of 2000, it had taken the Nasdaq two years to lose $4.6 trillion. Twenty years later, markets sliced nearly $6 trillion off the value of global equities in a week.”
Neoliberalism as practiced by the European Union had imposed austerity on its debtor members like Italy and Spain. That in turn weakened their public health systems and exposed them to the early onslaughts of COVID-19; they locked down because they had no choice.
Tooze notes that neoliberalism considered surplus production capacity an inefficient drag on profits, so as countries scrambled to obtain personal protective equipment and other medical essentials, they found such items had been outsourced to China.
‘Public life across the planet had stopped’
More shocks followed. With Indian Prime Minister Narendra Modi’s “lockdown and scatter” order, as many as 20 million urban workers had nowhere to go but home to their villages, and so “there were 122 million fewer people employed in April 2020 than a year earlier,” Tooze says. He estimates that by the beginning of May India’s unemployment rate exceeded 27 per cent — comparable to China’s.
“The entire world was now shut down,” Tooze writes. “It was like nothing ever before experienced. Piece by piece, public life across the planet had stopped.”
The world faced a depression based on both lack of demand and lack of supply. “Weeks ahead of government-mandated lockdowns in most of Europe or the United States,” Tooze writes, “global financial markets were in flight mode. There is no better example of the way in which news of the coronavirus induced a private search for safety — a shutdown.”
The Americans, standing on the edge of the abyss, stepped back and did the unthinkable: they released “limitless cash” into the national economy. We did something similar, and in both countries we paid attention to the workers and small businesses rescued by a flood of money.
But the real beneficiaries were “that small minority who had a substantial direct stake in the financial markets. It helped to revive corporate fortunes more generally and thus revive the economy.”
However grateful we might be for deferred rents and cash for the laid-off, the rich had reason for more gratitude: “Worldwide,” Tooze writes, “the wealth of billionaires rose by $1.9 trillion in 2020, with $560 billion of that benefiting America’s wealthiest people. Among the surreal and jarring juxtapositions of 2020, the disconnect between high finance and the day-to-day struggles of billions of people stood out.”
That disconnect stands out even more clearly in late 2021. The World Inequality Report, released on Dec. 7, found that “In 2021, after three decades of trade and financial globalization, global inequalities remain extremely pronounced: they are about as great today as they were at the peak of western imperialism in the early 20th century. In addition, the COVID pandemic has exacerbated even more global inequalities. Our data shows that the top one per cent took 38 per cent of all additional wealth accumulated since the mid-1990s, with an acceleration since 2020. More generally speaking, wealth inequality remains at extreme levels in all regions.”
Tooze’s book is inevitably out of date; it was published last spring, and events have overtaken it. But he accurately describes the economic battle as one “between right populists and centrists, and the centrists had the stronger hand.” For the all the American populists’ yelling about “Marxists” and “communists,” the left has had little impact on the recovery of the global economy. If they had, we might have seen serious taxes on the rich and a narrowing of inequality.
Instead, Tooze observes: “In an earlier period of history this sort of diagnosis might have been coupled with the forecast of revolution. If anything is unrealistic today, that prediction surely is. Indeed, radical reform is a stretch.” This is not because he can’t imagine a revolution, but because our responses “are conditioned by our situation in the here and now, by our history in the ‘before times,’ by our expectation of the future to come.”
The pandemic and climate change, combined, have triggered what Tooze calls a “great acceleration,” when events outrun earlier predictions and solutions. We will therefore have to improvise new solutions — or, like the populists, stick to a very old non-solution of anti-science white supremacy in the hope of returning to the “before times.”
The imperial infection
Rupa Marya, an American physician of Indian descent, and Raj Patel, a British academic, journalist and author, offer a solution from the before times in their book Inflamed: Deep Medicine and the Anatomy of Injustice. They argue that this pandemic, like countless disease outbreaks before it, is a consequence not just of a virus but of an imperialist world order that triggered disease and then built a medical system to serve the rulers, not the victims.
This is not some radical Marxist spin, but established medical history. In the early 19th century, British development turned wetlands into farmlands in what is now Bangladesh, and brought a marine bacterium called Vibrio cholera into human guts. Cholera rapidly migrated on trade routes to London and beyond.
In London, Dr. John Snow founded modern epidemiology by spotting the precise well that was infecting the neighbourhood. His medical colleagues dismissed his idea, but eventually Britain rebuilt its water supply system and greatly improved its workers’ health. Travellers from India were screened at Suez to try to stop further outbreaks from reaching Europe. But like Omicron, cholera was all over the planet by the time it was recognized.
Marya and Patel are by far the most radical analysts of this pandemic. They have no interest in blaming Donald Trump or the CDC; they are just the agents of a system created to serve the interests of 19th century empires, and which now protects the white heirs of those empires while ignoring the “essential” workers who serve those heirs.
The authors have strong confirmation from others like Alex de Waal, whose recent book shows how Louis Pasteur’s germ theory defeated the German scientist-politician Rudolf Virchow, who had long argued for social and economic inequality as the root of disease outbreaks. Pasteur had blamed individual microbes, which could be isolated, fought and defeated like rebellious tribesmen in some remote colony. We still fall back on war metaphors to describe our response to the pandemic.
Both men were right, but accepting Virchow would have caused severe political upheaval. So governments stuck to Pasteur and trained their health-care workers accordingly.
This had a convenient effect: white citizens of empires, including the U.S. and Canada, followed medical advice and stayed healthy. Disease outbreaks continued, but they were largely confined to the poor and the non-white. Henceforth, they would carry the stigma of disease carriers, to be kept in their slums or on the other side of the border.
Marya and Patel make it clear that this strategy has aggravated the pandemic: “When COVID puts us all under lockdown, capitalism magnified the crisis. The SARS-CoV-2 virus that causes COVID thrives in places of incarceration. By the end of 2020, one in five prisoners in the United States were infected, and thousands were dead.... COVID spread where elders are warehoused, in nursing homes where aging has become a condition to be managed rather than honoured.” The Tyee and other media have documented the consequences.
The authors also offer a useful word: exposome, the positive and negative factors that influence our health and longevity. We may be exposed to asbestos and smog, to vaccination and misinformation, and our lives depend on exposure to more help than harm. This is why every social class is healthier than the one below it, and sicker than the one above it.
And why women and workers are usually sicker than men and managers. Another recent Tyee article explains how workers have been ignored by the media and women left to carry the burden of caring for their families. Worse yet, the victims of the pandemic have been blamed for their own sickness:
“The modern individual,” Marya and Patel write, “has been made through centuries of disconnection — from the world around us, from others, and even from our own bodies. While wellness trends can help to reconnect on some level, they incorrectly focus on the power of an individual to improve their own health while ignoring — or worse, defusing — another power: our ability to collectively dismantle the hierarchies that caused these disconnections and consequently a large share of the illnesses that we face.”
That disconnection means that individuals are to blame for their own ill health — a view very well expressed just the other day by Colorado Gov. Jared Polis:
“You know, public health [officials] don’t get to tell people what to wear; that's just not their job. Public health [officials] would say to always wear a mask because it decreases flu and decreases [other airborne illnesses]. But that’s not something that you require; you don’t tell people what to wear. You don’t tell people to wear a jacket when they go out in winter and force them to [wear it]. If they get frostbite, it’s their own darn fault. If you haven’t been vaccinated, that’s your choice. I respect that. But it’s your fault when you’re in the hospital with COVID.”
And of course it’s not the governor’s fault if your hospital is underfunded and run by overworked, burned-out doctors and nurses who also have to look after the people you’ve infected because you haven’t been vaccinated.
The patience of the victims
A striking aspect of this pandemic is the patience of the victims. Even the countries with the highest case counts and death tolls, like the U.S. and Brazil, took their casualties without demanding a serious reckoning from the leaders who were obviously making matters worse. At most, the pandemic cost Donald Trump re-election; Jair Bolsonaro is likely to rule Brazil until the next election. No government has been overthrown for its sheer incompetence. Instead, it’s the individualist anti-vaxxers who harass health-care workers and attack school boards that want students to wear masks.
Perhaps this is in line with Adam Tooze’s conviction that not even radical reform, never mind revolution, is in the cards for the U.S. What most of these books reveal is a kind of political inertia, a conviction that the world that ended in 2019 will somehow, sometime, reappear.
So Elaine Dewar worries about Chinese espionage in Manitoba and unethical research in Wuhan as aspects of a new cold war comfortingly similar to that of the 20th century. Lawrence Wright focuses on the U.S., with the rest of the world as just a backdrop for the pandemic’s new challenge to American supremacy. Adam Tooze looks at the pandemic as serious challenge to neoliberal globalism; perhaps its 40 years of dominance are ending, but he can’t imagine its replacement as being much different.
Rupa Marya and Raj Patel are the only writers who define the entire 2019 status quo as the root cause of this and all previous pandemics: it was implicit in the European conquest of the Americas, in the European empires in Asia and Africa, and in the systematic imperial attack on stable ecosystems around the world.
That attack freed microbes from their own ecosystems and launched them on their own imperial adventures: cholera from Bangladesh to Haiti, HIV-AIDS from central Africa around the world, Zika virus from East Africa to Brazil by way of Polynesia. SARS-CoV-2, whatever bat cave it originated in, is the greatest viral imperialist yet. It hasn’t killed as many as the Spanish flu of 1918–19 did, but it shows every sign of sticking around forever.
Marya and Patel’s “deep medicine” seems like an impossible remedy for societies as atomized as ours. It involves tracing individual cases back into history, perhaps over centuries. Deep medicine doesn’t just ask if the patient picked up SARS-CoV-2 at a fraternity party or while changing planes at Heathrow. It wants to know how the patient ended up at that fraternity or that particular moment at Heathrow.
A deep-medicine diagnosis simply requires more social capital, more trust and reliance on one another, than we now possess. Marya and Patel’s readers are likely to have been overwhelmingly brought up on the principles of imperial science, which dismisses the scientific findings of its Indigenous predecessors. They will be hard to sell on deep medicine.
Viruses don’t care about our social problems any more than did the Canada geese I watched flying north one morning in early 2020. As we were locking down, they were getting on with their own lives, just as viruses get on with their non-lives. If we eventually suppress SARS-CoV-2, a new virus will escape from some clear-cut forest or factory pig farm, and we’ll be back at square one.
Adam Smith famously observed that “There is a great deal of ruin in a nation.” By that he meant you can run a country into the ground and it will still come back. Canada and the other self-styled “advanced” nations still have a lot of resilience. Many poor nations have exhausted their resilience, and sent their emigrés north to the Mediterranean or Texas. The rich nations will eventually realize they’re running on fumes and begin their own retreat: from the coasts to the interior, from the cities to armed enclaves like those of Rome’s decline.
Eventually, the survivors of climate and pandemic crises will abandon their enclaves and try to earn a subsistence out of whatever is left. Perhaps new ecosystems will replace our cities; it happened to a civilization in Honduras that we know nothing about because European diseases destroyed it even before the Spanish arrived.
Or perhaps the survivors will define a new deep medicine that draws on the deep past as well as the war metaphors of imperial science. We’ll never know, but we can hope.