The next big one?
A new book on pandemic responses raises questions about government, media, personal liberty, and public health
THE WISDOM OF PLAGUES: Lessons from 25 Years of Covering Pandemics
By Donald G. McNeil Jr. Simon & Schuster, 384 pp., $28.99
When Donald G. McNeil Jr. left The New York Times in March 2021, the newspaper lost an expert on pandemics right in the middle of one.
Now McNeil has rebounded with “The Wisdom of Plagues,” a useful, wide-ranging primer on how societies have mucked up their pandemic responses and can do better in the future. Here McNeil’s characteristic bluntness, paired with his deep knowledge of the subject, proves a virtue. “I have a history of getting in trouble by speaking my mind…,” he writes. “I know I’ll provoke anger. I don’t care.”
In the book’s compelling final section, “Some Ways to Head Off Future Pandemics,” McNeil advances suggestions he knows to be controversial. He favors, for example, the judicious use of vaccine mandates and the elimination of the so-called religious exemption. Such exemptions have no doctrinal basis, he argues, and have negative consequences for society as a whole. He calls them “a persistent absurdity in public health” and “red herrings exploited by the anti-vaccine industry.”
Not all of what McNeil proposes will stir ire. In common with other public-health experts, he favors better surveillance of looming pandemics, as well as cheaper medicine. Like many, he sees the US Centers for Disease Control and Prevention as lumbering and ineffective. During “the worst pandemic in modern times…,” he writes, “no one was accountable.” He proposes “a Pentagon for disease,” with clear lines of responsibility, as well as compulsory service by medical professionals, better science education, and (however unlikely) required medical checkups.
A former foreign correspondent, McNeil stresses the need to combat poverty around the world to stop pandemics. He notes, too, the benefit of enlisting the aid of “witch doctors,” practitioners of traditional medicine who enjoy community trust.
The book’s sometimes meandering earlier sections, exploring the roots and human accelerants of pandemics, are most riveting at their most personal. McNeil’s early alarm at the news from Wuhan, China, about COVID-19 was visceral. “This is it,” he reports telling his editor at the end of January 2020. “This is the Big One. This is going to be 1918 all over again.”
Even after public-health bigwigs endorsed his prediction, McNeil recalls, “I faced a mountain of disbelief,” including at the Times, where he was “occasionally… reprimanded for my tone.” The story, the biggest of his career, came to obsess but also exhilarate him, he says. At night, he would down four glasses of wine to get to sleep, only to be jolted awake a few hours later by nightmares. “I felt like Cassandra, the prophetess condemned to see the future but never be believed,” he writes.
Judging from this book, McNeil won’t be winning any civil libertarian awards. He admires, to some extent, the “harsh measures” China initially took to quash COVID-19. He compares that clampdown to Cuba’s “iron fist” approach to halting the spread of AIDS by confining the infected to quarantine camps. “I’ve come to feel,” McNeil writes, “that the Western focus on personal liberty above all else can kill.”
McNeil faults “poor leadership” in the United States for a COVID death toll that exceeded even that of other democracies. He would have favored a balancing of “lost freedoms against deaths averted” — a subtle prescription that proved elusive.
McNeil calls out the various ways that people have made pandemics worse. They have, for example, stigmatized the communities where diseases have first taken root. And while governments have too often chosen secrecy and cover-ups, populations have countered with denialism and fatalism. Cultural misunderstandings have hindered prevention and treatment. Profiteers have pushed ineffective nostrums — for COVID, drugs such as hydroxychloroquine and ivermectin — and conspiracy theories that have deterred vaccination.
“Freedom of speech does not include the right to market lies that kill American children,” McNeil writes. (Or adults, one might add.) Doctors “who tout false cures or denigrate approved vaccines should have their licenses revoked,” he writes, and “if their patients die, they should face manslaughter charges.”
Though he mostly prefers science to politics, McNeil admits that in some instances science has failed or been too dilatory. In the case of COVID, it took a while for transmission to be understood, for the value of masks to be confirmed, and for the virus’s extreme mutability to be observed. Sometimes, he writes, “scientists dither as they wait for rock-solid proof, while politicians are forced to act on instinct.”
The media and the public-health establishment, he suggests, tend to be synergistic, for good and ill. “All media pretend to be objective, and all media are biased,” he says. He portrays his Times editors as veering between excessive caution and overeagerness. But he admits that he, too, made errors — hyping the possibility of surface transmission of COVID, and falling prey to the deceptions of scientists who hid fears that a lab leak had started the pandemic. He now considers the debate about COVID’s origins to be stalemated.
Throughout “The Wisdom of Plagues,” McNeil wrestles with a skeptical, even tragic, view of human nature. But in the end, he inclines to a stance of measured optimism. “The blunt truths that science produces — and that good journalism defends — do tend to win out … albeit slowly,” he writes. “I’ll wait.” The question is whether the rest of us can afford to.