Book Review: "The Premonition: A Pandemic Story"
Michael Lewis' new book is a haunting narrative about the flawed responses to the pandemic.
I remember reading Michael Lewis’s book The Fifth Risk shortly after it was released in 2018 and being completely blown away by his ability to capture just how much damage Trump had been able to do to the federal government in a relatively short time. When I saw that he had a new book coming out on the pandemic, I knew that I was going to have to read it.
As with so many of his other books, Lewis hones in on a few key characters that drive the story. Out in California there’s Charity Dean, a public health official who, from a young age, has harbored a secret fascination for disease and its terrible effects. Time and again, both before COVID and certainly during it, she finds herself stymied in her efforts to mitigate disease by the clunkiness of bureaucracy and the chronic dysfunction of the state government (particularly its obsession with optics).
On the East Coast there are Carter Mecher and Richard Hatchett, both of whom were instrumental in the Bush administration’s efforts to set up a plan for a possible pandemic (Bush, apparently, was inspired to do so after reading a book about the 1918 Spanish flu epidemic). Though they find themselves increasingly sidelined with new administrations, neither of them are quite able to give up on their commitment to the health and well-being of the general public.
When it becomes clear that COVID-19 is going to hit the US like a thunderbolt, these extraordinary people join together and do everything in their power to mitigate its worst effects. As some other reviewers have pointed out, they become almost like heroes in a thriller movie, racing both against time and against the limitations of government bureaucracy, and that’s one of the book’s great strengths and one of its weaknesses. It obviously keeps us very invested in reading, racing from one page to the next to see what will happen, but it also tends to give readers a rather skewed (if not downright negative) view of the federal and state governments that are responsible for their well-being (both during a pandemic and in more normal times).
Reading the dust jacket, you’d be forgiven for thinking that the villain of the piece would be Donald Trump (and it would be easy to paint him as the villain, given his atrocious mismanaging of almost every aspect of the pandemic). If anyone comes out of this book much the worse for wear, however, it’s the Centers for Disease Control, which seemed either unwilling or unable to overcome institutional inertia and implement the necessary strategies to mitigate the effects of the pandemic. Rather than embrace such strategies as social distancing, for example, they instead continued to insist on isolating the infected and getting the vaccine to as many people as possible. In Lewis’s telling, they took the mantra: do no harm to a ridiculous extreme, time and again choosing caution over executive action. As time would show, this was a dreadful misstep on their part, leading to a great deal of unnecessary suffering and death.
There are some other decidedly unpleasant (yet absolutely necessary) revelations in this book, among them the reality that we don’t really have a unified healthcare structure in this country, let alone a unified response team in the face of a pandemic. Of course, a lot of this was evident at the time, perhaps most notably the fact that the US struggled to implement a unified testing strategy for far too long, allowing the virus to continue circulating through various populations virtually unchecked. It’s infuriating to read about the gross incompetence and bureaucratic nonsense that stymied early efforts to undertake contact tracing, but for that reason alone this book is worth reading.
One of the things that struck me about this book was how much detail Lewis was able to cram into roughly 300 pages. Given that we’re dealing with a tremendously delicate and complicated subject, it takes a very gifted writer indeed to convey to us a story that, while obviously somewhat reductive (it’s very easy to see the difference between heroes and villains in Lewis’ work) is still surprisingly complex. To my mind, one of the book’s most useful bits of information concerns the change to the CDC leadership that took place during the 1980s when, under Reagan, the director became someone appointed by the president rather than chosen from among the rank-and-file. In addition to poisoning the position with politics (an unfortunate phenomenon that has affected almost all areas of the federal government), this shift also meant that no one person was in the position long enough to develop the sort of long-term institutional experience necessary in times like the present.
Perhaps more than anything else, The Premonition is about seemingly ordinary individuals doing extraordinary things. As the pandemic unfolded, people like Dean, Mecher, and Hatchett attempted to do what was best for the country at large, even if it wasn’t politically expedient or presented “bad optics.” Though they can at times seem a bit superhuman--Lewis’s continued insistence on Dean’s almost supernatural ability to perceive or predict things feels more than a bit overwrought (though it obviously makes for a very compelling bit of storytelling).
Just as The Fifth Risk demonstrated the absolute necessity of having experts in government, so The Premonition reminds us of just how fragile and unwieldy our national health system was and remains. One can hope that we have learned our lessons from the last year and that, should we find ourselves faced with another major health crisis of this magnitude, that we will be a bit more prepared to take the necessary steps in order to ensure that over half a million Americans don’t die of yet another highly-infectious disease. However, I have to say that I’m not particularly optimistic. As this book makes clear, there are far too many people, both in government and in the general populace, who are willing to let inertia decide what they should and should not do.