Overview (Spoilers Abound):
Having been a fan of Lewis’ other works, i.e., Moneyball and The Big Short, I was excited to learn that his upcoming book, The Premonition, would dive into the United States’ pandemic response to the Covid-19 crisis. Due to the politically charged nature of the past year, I was curious if any bias would be discernible, however the only apparent frustrations were directed toward the Centers for Disease Control (CDC) and originated in interviews. As with his other books, Lewis relies heavily on interviews to drive his narrative.
The Premonition begins by highlighting how the nation’s first Pandemic Preparedness Plan came to be drafted during George W. Bush’s presidency. Lewis details the individuals who created this document, bringing their unique personalities to life through anecdotes, often dating back to their childhoods. I found it fascinating the decisions were made regarding various aspects of the plan and how each chapter seemed to have a key backstory. As a scientist, I appreciated the research and thoughtful effort that these individuals, specifically Richard Hachett and Carter Mescher put into drafting each section, often expending great effort to contradict established norms when emerging evidence contradicted, regardless if the solution was unpopular. For example, they used mathematical models to prove that closing schools would be a game changer in preventing a hypothetical virus from spreading. As a side note, Lewis also highlights how this mathematical model, which proved less cumbersome than other more complicated models, had its origin as a child’s science fair project. As an aside, Lewis mentions several times how Mescher has the ability to live behind the scenes but still influence the direction and progress of a project. I did a cursory internet search to see what Mescher looks like or verify some of Lewis’ claims, but I mostly only found articles relating to this book.
After establishing who the researchers are and the drafting of the plan, Lewis follows the nation’s response through the swine flu (H1N1), SARS and MERS, right up until Covid-19. Specifically, he focuses upon Mescher’s role, who remained working for the White House the longest but had returned to his position at the Veterans Affairs Hospital. He was still running an email chain for like-minded pandemic conscious individuals when the first rumors of Covid-19 were being picked up. As Covid-19 became a more prominent threat, these emails shifted to weekly calls that included individuals from all over the country and worked to influence responses. For example, Maryland and Ohio had public health officials on the calls and it resulted in proactive, aggressive responses to the virus. Lewis detailed how influential these ‘unofficial’ meetings were and how policy changes resulted from their discussions. At this point, focus of The Premonition narrowed to California and the challenges that one public health figure, Charity Dean, encountered while trying to get her state in front of the virus from advocating for establishing efficient testing (while the nation waited for the CDC to develop their own Covid-19 tests), to starting conversations about mandates that needed put in place. Interestingly, Lewis pulls some punches here because he doesn’t delve into the fact that the initial tests the CDC shipped to labs were faulty. Lastly, Lewis dives into the history of the CDC, highlighting previous mishaps that lead to this scientific establishment becoming a political tool.
I work in public health as a chemist for the State of Michigan and had a front row seat (down the hall) to Michigan’s Covid-19 response from the lab perspective, e.g., waiting on initial test kits to juggling between testing platforms depending on what supplies were low on that day. The lab kicked butt and worked an insane amount throughout those months to deliver tests with quick and accurate turn arounds. While The Premonition focuses mainly on California’s effort, there were struggles in labs across the country and it was interesting to read about mirrored experiences and troubleshooting that had to be employed to keep sampling moving forward.
Overall, I finished The Premonition with a much better understanding of how the United States had been prepared for a pandemic and inner workings of public health that shifted into place once the danger of Covid was realized. Unfortunately, our response was significantly delayed compared to what Hatchett and Mescher had envisioned upon drafting the Pandemic Preparedness Plan. I couldn’t help but draw correlations between the FDA and Kathleen Eban’s Bottles of Lies and The Premonition with the CDC. Upon writing this review, I wanted to spend much of it spouting facts gleaned from The Premonition (such as Zimbabwe had Covid-19 tests before the United States), which is a sign of a great nonfiction read however, I’m going to resist those urges and let you learn them yourselves!