“But what does it mean, the plague? It’s life, that’s all.”
Albert Camus’ matter-of-fact quote describing the hellish episode in history is found below a clinical definition of the word pandemic, on the opening page of this tome, aptly setting the bleak tone of an exhaustive narrative on the global crisis that our world is still reeling under.
Written by the award winning investigative science journalist, Sonia Shah and first published in the United States by Sarah Crichton Books in 2016 (yes, well before the COVID 19 catastrophe hit us), the book went on to garner glowing reviews and is even recommended as ‘required reading’ by The New York Review of Books.
The book was first published in India by HarperCollins Publishers only in 2020 (when SARS-Cov2 had already found its way across the globe), with an updated preface worded by the author from “depths of quarantine, at a moment of maximum dread and despair.” She ominously predicted that “the other side of the pandemic remains blurry and dim… whether it will arrive remains an open question.”
As of September 2022, as we see the mutated progenies of the killer still infecting our masses, her observations about the previous pandemics- “…as soon as the heat of contagion lifted, we resumed doing the same things we’d done before…” seem accurately and tragically prophetic.
She introduces us to her topic citing Rita Cowell’s Cholera Paradigm, suggesting that the trends of emerging diseases can be understood by studying the well documented emergence and spread of Cholera. She embarks upon her research by travelling through the slums of Port-au-Prince in Haiti- tracing the dreaded vibrio cholerae; the wet markets of South China analysing the birthplace of SARS; and the surgical wards of New Delhi looking for the origins of the pernicious NMD-1 plasmid.
We are taken back in time and across continents, through murky by lanes of history and geograpghy, in a spectacularly graphic visualisation of the workings of a pandemic.
Her painstaking research, arranged in 10 distinct chapters, is impeccably articulated, such that you are taken down to a microscopic scale right into the enemy territory of the wily pathogens. They originate in animal reservoirs making their Jump between species, and display their tenacity as they survive the Locomotion across the globe, prospering in the Filth created by us, amplifying within our Crowds, aided by our Corruption and benefiting from our Blame games before finally diminishing through Cure. She further discusses ecological impact on spread of pathogens in The revenge of the sea, before summarising The logic of pandemics and deliberating on the clues that might help in Tracking the new contagion.
While discussing the management of these situations, Shah has voiced concerns over reductionist approach of contemporary medicine in singling out a culprit pathogen, versus the holistic Hippocratic approach in combating the hydra headed problem of mutating and evolving pathogens in a complex ecological system. She unabashedly shines light on the gaping defects in the fabric of our surveillance systems and the rigid spanners stuck in the clockwork of our healthcare machinery. Our fragile supply chain network and overworked transportation system is shown to crumble like a flimsy house of cards in wake of such calamities, resulting in losses that go beyond human casualties, leaching into our socioeconomic frameworks and pushing us towards yet another impending depression.
The book effectively challenges our position as the most successful species inhabiting the earth by pitting us against these invisible and invincible demons. Our fallacies lie in our erring nature of denial and general lethargy in taking action. To use the author’s own words: “We did not grapple with our complicity in their spread… we did not make space for them in our historical memory and by denuding pandemics of their social character… we became their unwitting allies and they came back again and again.”
After a hellish ride through the inferno of pandemic history, Shah’s Virgil (a title bestowed on her by Chicago Tribune) discusses possible strategies for nipping a potential future pandemic in the bud- for example organisations like Healthmap, Ascel Bio, and other laboratories engaged in surveillance of potential hotspots (Though from the current perspectives, these measures may be deemed- too little, too late).
The failing of the book (if one is compelled to look for it), is its story-telling narrative. While it makes for a remarkably detailed piece of chronicle and a compelling work of literature, a significant chunk of research material used is anecdotal data. Given our ongoing tryst with the latest pandemic, a lot of us (especially the readers of medical fraternity) look for answers in evidence based projections and predictions, the way actuarial studies endeavour understanding economies.
But this in no way diminishes the mountain of work put into the making of the Pandemic, nor does it diminish the experience of reading its utterly engaging outcome. A highly recommended read for anyone trying to make sense of how an ultramicroscopic virion that originated in Wuhan, found its way into their own bodies, miles across continents, despite our self-assured healthcare advances.