Laurie Garrett

A very long book which deserves a slow careful read. I had had it on my shelves for a long time and finally took it down to read during the current pandemic. And it is all there in these pages: the warnings from 1994 of emerging diseases due to (then in early stages) climate change, misapplied efforts to clear up certain organisms (allowing worse ones to take over in no longer balanced ecosystems), increasing infringement on wild places bringing humans in contact with animals that carry diseases, often harmless to the animals but deadly to humans, inadequately funded health care systems, not just in the developing world but also in countries such as Russia and Romania, leading to multiple use of hospital syringes and hence direct bloodborne infection - for a lot of diseases often far more lethal than ordinary person-to-person transmission - infection of blood banks due to lack of any sterilisation procedures or screening of donors (many of whom were needle-using drug addicts who were paid to donate blood), and overuse of antibiotics in both agricultural and hospital settings allowing mass resistance to the same on the behalf of multiple disease causing organisms including some previously thought to be brought under control such as tuberculosis. All described through chapters which focus on particular diseases such as Lassa, Ebola, HIV and so on.

Particularly scary was the information that bacteria and other microbes freely exchange pieces of DNA and also take onboard freefloating fragments in their environment which confer on them such handy attributes as antibiotic-resistence and increased virulence. One of these fragments bestow on the receiving microbe the ability to form a pump which pushes back out of its cell wall anything that might harm it - such as antibiotics or even, in the case of micro-organisms contaminating water supplies, chemicals such as chlorine, rendering them impervious to the effects of such chemicals. Even cancer cells use the same mechanism. And all these things are swapping around DNA to improve their ability to infect and survive any attempt by humans to control them.

To summarise: this is a very informative book. The only reason I haven't given it 5 stars is not because it would need to be brought up to date to reflect how the situation has worsened since, but because the author has a tendency to try to tell the 'stories' of some of the doctors or victims of disease and jump back and forth in the timeline so that when they reappear pages later you can't always remember them. There are also a lot of people to remember anyway given the huge numbers of microbiologists, virologists and others involved in the history of these diseases. But a solid and very sobering 4-star read… (mer)

The plague came, and will come again. The story repeats over 50 years of fighting urban and rural epidemic: A small band of field researchers are left to improvise missions of mercy against the next mysterious contagion and its potential global spread. If anything got us through the coronavirus it was that many of the same people that fought AIDS, Ebola and other scourges hung on after their bosses moved on. This history of midcentury microbial threads predates SARS as well as COVID yet foreshadows them repeatedly and depressingly.… (mer)

I finished! Started in April, finished in December.

This book is from 1993 so there is no SARS, MERS, or Covid-19. But this is a great overview of historic emerging diseases (Machupo, Ebola, Toxic SHock Syndrome, new flus, Hantavirus, and many more) and the scientific and cooperative work that has gone into learning about vectors, contagion, treatments, and so on. She discusses the political problems of getting funding and recognition for AIDS around the world. Near the end Garrett does begin to address the ranpant budget-cutting that had started in the US, and what it might mean for the future.

This took me so long to read because I got bogged down a few times. The chapter on the 1976 flu was slow because nothing happens--which is the point. What happens to public health trust and funding if the scientists models are incorrect?

Several of the later chapters are science-heavy (though my microbiologist friend disagrees LOL), as they discuss how viruses mutate. There are also a lot of numbers--costs, risks and percentages, absolute numbers, rates per place or population, etc.

All in all, this is an excellent book. A little hard to understand in places, and obviously not up-to-date. I would love to see an updated edition or part 2.… (mer)