| Title | : | The Coming Plague: Newly Emerging Diseases in a World Out of Balance |
| Author | : | |
| Rating | : | |
| ISBN | : | 0140250913 |
| ISBN-10 | : | 9780140250916 |
| Language | : | English |
| Format Type | : | Paperback |
| Number of Pages | : | 750 |
| Publication | : | First published January 1, 1994 |
The Coming Plague: Newly Emerging Diseases in a World Out of Balance Reviews
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A 25 year old, unheard, ignored Cassandra call full of detailed descriptions, this book deals with the question of how the evolution of killer viruses, potential pandemics, plagues, sexually transmitted epidemics,... may continue in the future.
Garrett describes the connection of third world poverty and the spread of diseases, something completely ignored by mainstream media because of the political and economic implications, except an epidemic gets too extreme and gets NIMBY. This, chapter 14, named "Thirdworldization" is a reason for shame for the rich, industrialized countries, but what is not?
The general question is, as so often, not if, but more when, how, where and hopefully not me.
When: There are many ticking time bombs, be it manmade problems with superbugs due to overuse of antibiotics, urbanization with more and more people living close together, the possibility of spillovers in companion with natural destruction, as unexplored areas with new species of primates are exploited, other manmade problems like side effects of genetical engineering, the option for use as biological weapons, climate change and global warming that help germs immigrate to new territories and possibly frozen ones come back to live, terrible public health and prevention politics, no further development of new and preventive vaccines and antibiotics because there is no money to make with this stuff, except if it is the flu,...
How: As an element of warfare or one lumberjack, being bitten by a monkey or getting in contact with body fluids spreading it in his hometown and from there to a larger city to the capital to….. Or a multiresistant superbug out of a secret biowarfare lab or an industrial farming facility, whatever the difference is, the farming might get much more subsidies. There are so many great film plots around this.
Where: The only positive thing. If one doesn´t live in a larger city, but a rural area, by simply shooting everyone nearing the village after the breakout, bad things can be prevented and outposts have a long tradition of hating anything foreign, so that should work well. Except when there is a longer state of emergency, break down of infrastructure and food supply, leather rockers cannibalizing around, virus apocalypse, yada yada yada.
The author is a biologist with specializations in bacteriology and immunology who switched to journalism and the chapters read like great storylines for hard biopunk Sci-Fi stories. The underrepresented biopunk genre deserves more authors who are biologists, geneticists, bioengineers,... So please, take a creative writing course and create the next big thing, because the Sci-Fi hall of fame is filled with just mostly astrophysicists, chemists, physicists and similar, mainly not bio-focused, authors.
All of the points the author mentioned a long time ago, the suggestions she made on how to be able to deal with the problems have been commendably solved by a wise and united world government and public-private partnerships with international institutions that... Just joking, we are doomed (when living in large cities)! Doooomed. (I love to say that.) Now, it´s really enough. Ok, once again: „Move along people, nothing to see here. The government is competent and capable to deal with the situation.“
One more: They build bioweapons by combining elements of something extremely deadly like smallpox or ebola with the flu and anything that can spread by air and is extremely contagious. Something like a droplet infection that spread genetically enhanced HIV, multiresistant tuberculosis, hepatitis C,… this way might be no effective immediate use bioweapon, but something for the long-term destruction of a country, especially if the own population is immune and vaccinated against it.
A wiki walk can be as refreshing to the mind as a walk through nature in this completely overrated real life outside books:
https://en.wikipedia.org/wiki/Pandemic
https://en.wikipedia.org/wiki/Zoonosis
https://en.wikipedia.org/wiki/Viral_h...
I read it inspired, or let´s say terrified, yes, that sounds much better, by the current coronavirus outbreak.
https://en.wikipedia.org/wiki/2019%E2...
CNN live updates
https://edition.cnn.com/asia/live-new...
John Hopkins CSSE world map
https://gisanddata.maps.arcgis.com/ap...
Youtube statistics
https://www.youtube.com/watch?v=qgylp... -
She nailed it in 1994. Maybe won't be COVID-19 but one of them. Terrific, informative, well-written, I still remember it but not surprised it's a bestseller again.
I was seeing a guy getting his Ph.D. at Harvard School of Public Health and leaving him even more sleep-deprived than your average Sci.D. getting a Ph.D. in public health by hitting him on the arm to wake him up multiple times a night as questions occurred to me. Maybe if I'd written them down we'd still be together. (Kidding!)
(Focus, Lori. You don't like reviews or reviewers who make the books about them -- cough cough [not a coronavirus cough...or is it?] -- Lolita.
Can someone please muzzle the orange lummox and Igor and let Dr. Fauci of our NIH run this? Tough choice: one's daddy paid to get him into school, then paid the school to take his grades and lock them up! -- and the other has been a worldwide leader in efforts to study and contain infectious diseases, especially AIDS and Ebola. -
A couple weeks after I read this wonderful book (years ago) I was walking across the Brooklyn Bridge and saw a woman that looked just like the jacket photo of Laurie Garrett. I stopped and asked "Are you Laurie Garrett?" And, of course, she was. Then I said something impossibly stupid--like "You are to disease what the Beatles are to music." That wasn't what I actually said, but it was something equally idiotic and I'm sure I embarrassed the poor woman.
I attended a reading she gave a few years later when she was releasing a book on the public health system, and afterwards I wanted to get her to sign my copy--but I was afraid she might remember me. And I was also afraid she wouldn't. So I just left when the lecture was over.
None of this speaks to this book at all, but there it is. -
Covers a lot of ground. We make the same mistakes in every pandemic. This was like reading a history of warfare. What is it with human institutions that we end up reacting the same way again and again?
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4 ☆ Science advances quickly, but so do the microbes
Nature isn't benign... we're not alone at the top of the food chain... The survival of human species is not a preordained evolutionary program.
So proclaimed Joshua Lederburg, a molecular biologist and Nobel laureate. Despite the speaker's prestige, human nature would want to dismiss his statements. But as the entire world is struggling, at great human cost, against viral Covid19 infection since early 2020, his declarations' veracity are self evident while his warning carries ominous heft.
Humanity's ancient enemies are, after all, microbes. They didn't go away just because science invented drugs, antibiotics, and vaccines... And they certainly won't become extinct simply because human beings choose to ignore their existence... lulled into a complacency born of proud discoveries and medical triumphs, [leaving humanity] unprepared for the coming plague.
More than 25 years have elapsed since the publication of The Coming Plague, and Laurie Garrett's thesis remains relevant today. Because as quickly as scientists have advanced in knowledge, the microbes (microorganisms such as bacteria, parasites, and viruses) are evolving just as doggedly. What's worse, however, is that she asserted that people are actually aiding and abetting microbes through a variety of actions ranging from ill planned development schemes, misguided medicine, errant public health to short-sighted political action or inaction.
Garrett illustrated her theme via historical accounts of disease outbreaks since the 1950s, when the health field was confident that humans had vanquished acute diseases. Hubris comes before the fall. Sometimes the records were of the unglamorous, globe-trotting sort with biologists trapping bats, mice, snakes, etc. to identify the disease-carrying vector. Other times, the scientists operated in imperiled circumstances due to military activity or they themselves became infected by the lethal pathogen that they were investigating.
As this book numbered 750 pages, Garrett included a long litany of horrors caused by microbes. The following were described at some length, and I've sorted them by their preferred modes of transmission:
Mosquitoes - malaria, yellow fever, dengue
Mice- Machupo (Bolivian hemorrhagic fever), Lassa fever, hanta-ARDS (acute respiratory distress syndrome)
Bats (best suspect) - Ebola
Monkeys - Marburg hemorrhagic fever
Humans - smallpox, meningitis, STDs (sexually transmitted diseases), AIDS (acquired immunodeficiency syndrome), tuberculosis
Water - Legionnaire's disease, cholera
Although the reading experience of this pathogen parade did not feel short, Garrett had only pointed to the tip of the iceberg. For in just 20 years when the US had established biological research stations throughout the Southern hemisphere, more than 60 viruses with terrifying impacts had been identified. The hemorrhagic fevers were quite horrific as they created holes in blood vessels, so patients bled from everywhere within and without the body. As many as half of the patients with the Machupo virus died from a seizure or cardiac arrest after their bodies went into shock.
Through Garrett's accounts, I learned new concepts that I really would have wished out of reality except that I'm not a 3 year-old. Starting with "iatrogenic" - which describes disease created as a result of medical treatment (ex. pediatric AIDS infection in hospital nurseries). This differs from "nosocomial" transmission, which is the two-way spread of disease between patients and medical staff. In the 1990s, virologists believed that the worst scales of disease and death occurred with "epizootic" events, which happen when a virus is benign with host animal species #1 but becomes lethal when the virus finds animal species #2. Underlying this, of course, was the fear of "zoonosis" (infectious disease caused by a pathogen that has jumped from an animal and into humans), which is what the world is dealing with now.Microbes are masters of genetic engineering.
Lederburg won his Nobel prize in 1958 because he discovered that bacteria can mate and exchange genes. As the new field of molecular biology has grown, they've since learned of the many genetic strategies microbes have to mutate and develop resistance to antibiotics and other pharmaceutical treatments. For the most part, Garrett wrote about the underlying science in an accessible way for the layperson. There were only about 20 pages on transposons, plasmids, and other microbial tactics of jumping genes which led to glazed vision from detail overload. Because of the improper use of antibiotics, many diseases are now more difficult and costly to treat. And becoming infected with something like MRSA just for being hospitalized is now not a minor concern.
Garrett's most extensive disease coverage was on AIDS, because that was the most recent and globally significant pandemic prior to her book's publication. She wanted to highlight the failings in response to that crisis in order for us to learn and thus prepare for the inevitable next pandemic. As I've followed the news, we apparently learned nothing. In the US, we were caught with our pants down, not only for the embarrassing handling of the Covid19 pandemic (WH "leadership" denial and agitation and faulty / inadequate testing) but for the massive, and still tabulating, cost in deaths (with disproportionate racial mortalities) and human suffering economically, socially, and psychologically.
By the end of The Coming Plague, one would have to engage in willful denial to ignore Garrett's warning. Humankind needs to change our mindset. We are vulnerable and microbes do not respect any physical walls; in fact, they'll live on them in hopes of finding their next host. There will be no success solely with a strategy of national isolation because as economies reopen, the resultant flows in trade and people expose everybody to danger (at least until the majority receive effective vaccination). And as we continue to change our planet in the extreme pursuit of development and wealth, we will continue to aid and abet microbes in their fight for survival to our detriment.
This is probably the longest nonfiction I've read outside of an academic setting, if not ever. The writing quality became less even as the book progressed. My reader fatigue was matched by editorial weariness, as I encountered more typos. Garrett had quit her doctoral program in immunology to become a science journalist. So she definitely has the necessary scientific background, but the writing could have been improved to strengthen her thesis. I would thus rate the message and content 4.5 stars but the reading experience between 3-3.5 stars at times for a final 4 stars. -
Ebola's back. Want to know how it all started? Read this book. If you're not terrified by the time you're done, you're not paying attention or you have far too much faith in the strength of man versus microbes. I read this for a graduate-level history class on "Ecology, Disease, and Population". Needless to say, we spent quite a bit of time studying how disease has shaped human history.
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3 stars
This book is in-depth. The focus is on history, detailed facts and what we can do to prevent and cope with new maladies. Even if the book is no longer new, it still teaches a lot. We can learn from past mistakes. For me, parts read as a horror story. Then I calmed down. It first came out in 1994, and hey, we are still here! Did I become immune to the horror?! Or did it finally put me to sleep? In places, it sort of felt like a text book. My education was not adequate for a complete understanding of some of the medical discussions. It is heavily footnoted and has an index too. It is no sensational, quick read. It is both scary and deadening. Yes, the pun was intended. The book is directed toward serious readers who want the complete history of the new plagues that have confronted us in the last century, think the Bolivian hemorrhagic fever, the Marbug virus, Yellow fever, the Brazilian meningitis epidemic, Lassa fever, Ebola, swine flu, Legionnaires’ disease, sexually transmitted diseases and injecting drug users, AIDS, toxic shock syndrome and what can be done to stop this trend. Elimination of a disease threat is inextricably bound to economics, development and politics. The fight against disease is inextricably a fight against world poverty.
Here is the truth: to complete this book I forced myself to read one chapter a day.
*************************
After Chapter 5: Definitely interesting but hard to read. I am no hypochondriac; I tend to treat pains with nonchalance in fact, but when you read this book you start worrying. You certainly get scared of traveling to Africa, and you wash your hands a lot.
Have decided to read a chapter a day, which is about all I can handle, due only to my own fears. So far I have learned about Yellow fever, Ebola, Lassa fever, Marburg virus..... -
This is my kind of horror book. I think it scared me more than just about any other book I’ve ever read, but I loved it. I appreciated the author’s skillful and entertaining story telling and admired her scientific accuracy.
I can’t vouch that the information is current; I read this when it was first published. At the time it was pertinent and I can’t imagine that the basic theory (regarding epidemics) isn’t still valid. I’d continue to recommend this to anyone who’s interested in medicine, disease, and human health.
I enjoyed this book so much that when Laurie Garrett was speaking in my city, I went to hear her; she’s very personable and knowledgeable. -
We're screwed. The microbes are going to win. And make no mistake, climate change is going to accelerate our death spiral. (Though writing in the early 1990s, Garrett discusses the effects of global warming on pathogen populations and spread.)
One of the most fascinating things about this story is that we are drastically underestimating the number of deaths from microbes and pathogens. If we actually had public health departments that were funded and functioned properly, if we funded public health and epidemiological studies and prevention efforts at the national level to match the need, if we did proper autopsies on everyone and performed the requisite tests, we would find the mortality rates from these infectious diseases jumping enormously. The truth is that many deaths from pathogens go unnoticed and unreported because they are not tested for; they are attributed to causes like pneumonia. (An example is Legionnaires' disease, which we associate with an isolated event in Philadelphia in 1976. But the bacteria that causes Legionnaires' disease probably killed thousands more people in the years after air conditioning systems were invented, and these deaths were attributed to other causes.)
Garrett's book is a masterpiece of reporting and synthesis that, with the exception of chunks here and there, reads like a novel. Just one tiny example of her thoroughness is a footnote in which she lists every major influenza pandemic since the year 1173, along with the probable origin, geographical scope, and estimated mortality of each. This footnote has its own footnotes (four different sources). And the book has more than 100 pages of footnotes. Some of them have more depth of reporting than a news article in a major newspaper.
The book is all the more astonishing in that due to an occupational injury, Garrett was unable to use a keyboard and wrote the whole thing in longhand. -
although it's now somewhat out of date, this remains far and away the most comprehensive and interesting book about diseases i've read. what sets this apart from the rest of the disease books on my shelf is the sheer amount of ground covered and how well it's presented. it doesn't particularly seem like it would be a fast read, yet it is.
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The human world was a very optimistic place on September 12, 1978, when the nations’ representatives signed the Declaration of Alma Ata. By the year 2000 all of humanity was supposed to be immunized against most infectious diseases, basic health care was to be available to every man, woman, and child regardless of their economic class, race, religion, or place of birth.
Weirdly, the fact that this book was published originally in 1994 – nearly three decades ago – does not mean it has no relevance to the current state of the world. Instead, reading it now offers a powerful contrast between what is happening, what we have failed to do as a global collective in the interim, and how so many of our current systemic epidemiological and public health issues have their roots in the past.
However, I am sure that Laurie Garrett can tack on a couple of chapters to her now-classic book? I recall reading somewhere that it is a New York Times bestseller again in light of Covid-19, so I am sure that bringing it up-to-date will only increase Garrett’s popularity and standing even further. (I do recommend following her on Twitter, as she always highlights the latest information and trends in a clear and concise manner, without the smoke-and-mirrors hyperbole so often used by mainstream media.)
Criticising the US response is relatively easy to do. But signposting the future is a far more difficult and risky prospect. It is the kind of responsibility that Garrett gravitates towards, especially as Senior Fellow of the Global Health Programme of the Council on Foreign Relations. And she lives in Brooklyn Heights in New York, which must afford her a front-seat view of the pandemic’s impact on that great city.
What is there to say about this book that has not already been said? I know that is a terrible copout as a reviewer, but I can honestly say that I found this essential but exhausting reading. Comments like “there is a deep worldwide undercurrent of concern about emerging diseases, and an obvious need to develop a comprehensive, global plan” resonate powerfully today. As does the below, which applies particularly to Africa:
“There will always be a need for an emergency response effort, and that will probably always primarily mean the CDC,” Joe McCormick argued. “But you need people on the ground to spot these things first. You need a health care system. And you need a place to call.” If the government is your enemy—if you and your people are victims of oppression—whom do you call?
One thing that struck me quite forcibly about this book is the role played by front-line scientists, the ‘disease cowboys’. Here Garrett highlights how critical Science is, as does SF author Kim Stanley Robinson about the impact of global climate change. But science never occurs in a vacuum. It needs data, and that data often has to be collected in the face of grave danger and personal risk (one only has to recall the dreadful Ebola virus outbreaks in Africa).
“Twenty years ago field epidemiologists were the real article,” Gubler explained. “They could do it all: field study on the ground, laboratory work, organism isolation, vector analysis. There’s a paucity of that now. And I can’t understand it, really. To me what’s sexy is to go out in the field—that’s where the excitement is. Maybe I’m a romantic, but to me what’s hot is going out, kicking around in the field, and seeing a disease in its natural ecology.” -
//2020 (COVID-19) Update:
--March 2020 pandemic global lock-down, here we go....
--The author has been appearing on American media to give her coverage of COVID-19, after her acclaimed coverage of 2002-03 SARS, Ebola, HIV, etc. Here's a playlist:
https://www.youtube.com/playlist?list...
--Warning: I do worry to what degree Garrett can critically analyze the American foreign policy factor given her proximity to it (Senior Fellow of the Global Health Program in the Council on Foreign Relations). Consider
Vijay Prashad's journalism on the Chinese government and peoples' responses:
-(interview):
https://youtu.be/p90MbPiUCMs?t=53
-(article):
https://www.thetricontinental.org/stu...
--The geopolitical factor is of course crucial to getting a complete picture of American/Western foreign policy (from overtly militaristic to covertly imperialist, including trade and "aide"). It is perhaps murkier in global health (abstracted from the direct political economy of poverty), where on the surface there seems to be greater conflicting pressures (from supposedly "apolitical", scientific technocrats). Stay vigilante.
--Furthermore, many health crises are symptoms of political economic crises that cannot be resolved by public health officials (ex. here in Vancouver, the opioid crisis is the other official "public health emergency", but this is tied to housing, employment, community, etc.)
--On the other hand, I've noticed a few anti-imperialists (well-versed in analyzing the violence of foreign policy, which is why I follow them) who would benefit from reading a broader range of topics (i.e. statistics, sciences, technology, etc.). Acknowledgement of my own limitations in various subject matters leaves me baffled by the self-confident leaps of logic that some take, where they start with discrepancies/failures in politics (where, of course, powers will be opportunistic with crises) and conclude with (very) amateur analyses of science/statistics (i.e. "hoax", "just the flu"...or even worse: pseudo-scientific musings on what is "natural" vs. "man-made" about viruses/immune system responses... Facepalm fallacies covered in
Bad Science: Quacks, Hacks, and Big Pharma Flacks).
--If you only have hammer, every problem looks like a nail; we all benefit from a more diverse toolkit.
//2018 Review of this 1995 book:
--750 pages covering 50 years of global disease control adventures… stunning narration by Laurie Garrett.
--Global inequity: while the scientific and technological changes to healthcare are visible in wealthy countries, we have at the same time clinics in the Global South that reuse un-sterile injection needles so often that they need to sharpen them on stones, due to the lack of supplies and education.
--Even wealthy countries require public funding for population health services and long-term R&D, which human parasites like the Reagan administration are eager to dismantle and privatize (first pillaging social wealth, then slapping on extra fees to extract further profits while sacrificing the dispossessed).
While I focused on the social factors, there were plenty of discussion around the biology of disease. Highlights for newly emerging diseases include:
1) Environmental disruption: human’s rapid expansion into previously isolated natural habitats opens exposures to new pathogens. A deeper analysis of the political economy/ecology that drives this would really complete the picture (i.e. the global market, urbanization/slums, capitalism seeking new markets and relentlessly commodifying nature, etc.)
2) Global transportation drastically accelerating the spread of epidemics.
3) Lack of global surveillance infrastructure to deal with these new threats. -
This is an amazing book. Garret gives an overview of all the nastiest diseases on the horizon: Ebola, Marburg...her central point, that expanding human territory is likely to increase contact with animal reservoirs, and that sooner or later, something is going to develop that is both deadly and swiftly spread.
Come to think of it, I'd love to read an updated edition. -
factual analytical article not op-ed
https://www.nytimes.com/2020/08/06/us...
U.S. has 4% of world population but, has 22% of the world's cases.
-----------
Another Copernican moment. No, we are not the center of the universe.
Man is embedded in nature. The biologic science of recent years has been making this a more urgent fact of life. The new, hard problem will be to cope with the dawning, intensifying realization of just how interlocked we are. The old, clung-to notions most of us have held about our special lordship are being deeply undermined.
—Lewis Thomas, 1975
===============
Some commentary from the book....
“Nature isn’t benign,” Lederberg said at the meeting’s opening. “The bottom lines: the units of natural selection—DNA, sometimes RNA elements—are by no means neatly packaged in discrete organisms. They all share the entire biosphere. The survival of the human species is not a preordained evolutionary program. Abundant sources of genetic variation exist for viruses to learn new tricks, not necessarily confined to what happens routinely, or even frequently.”
"If HIV was our model, leading scientists concluded, humanity was in very big trouble. Homo sapiens greeted the emergence of the new disease first with utter nonchalance, then with disdain for those infected by the virus, followed by an almost pathologic sense of mass denial."
"According to historian William McNeill, Cortez’s capture of Mexico City with just a small army of exhausted Spanish irregulars under his command was possible only because the Europeans had unknowingly spread smallpox throughout the land. When Cortez launched his final assault on the capital, few Aztec soldiers were alive and well. Smallpox, together with measles, tuberculosis, and influenza, claimed an estimated 56 million Amerindian lives."
-----------
On the author and her work....
https://www.nytimes.com/2020/05/02/op... -
This book terrified me.
If you think globalization and urbanization in distant places have had no ill effect on the quality of life on this planet, think again. We discover new diseases faster than we learn to treat them, and our current methods of treatment tend only to make the diseases stronger and more virulent. The author makes a grand case for a major change of mindset in funding not only medical research and health organizations, but also supporting basic human rights to safe living environments, clean water, and sufficient nutrition.
Anyone who has any degree of literacy should read it, especially those in positions of influence. I encourage everyone to buy several copies and send one to each of your representatives: local, state, and federal.
This copy will go to some government official, as soon as I figure out where it might do the best good.
(BTW, this edition was published in 1994. I wonder if a revised and updated edition is available. Such a revision would more than likely be even more frightening.) -
Want the skinny on Ebola? I mean, the answer to that is probably not because, frankly, it's kind of terrifying.
Let me put that a different way.
Want to hear actual facts and research about Ebola instead of news bites?
The Coming Plague was easily the best thing I read in library school. Yes, library school. Just examine that name for a second and guess how much reading a library school student does. And then remember that I said this was the best part of all that reading. Then have a snack because I've been ordering you around a lot here and I feel bad about that, so please, enjoy.
Author Laurie Garrett also wrote this great post, "5 Myths About Ebola" that you should probably check out:
http://www.newsday.com/opinion/five-m...
Okay, full disclosure, this is a long book. But it's not a long read. Sit down, read the first 20 pages, and by then you'll be hooked. And also maybe a little terrified. Happy Halloween, I guess.
-Peter -
I think I've gone into virus lit overload, because this didn't excite me as much as it should have. A lot of the chapters had very similar information to other books I've read (
I
really
love
viruses.
No,
seriously.). The HIV chapter was extremely comprehensive though, more than most virus books devote to it, so that was interesting.
I think this is a pretty decent overview on viruses, but nothing special. I preferred David Quammen's
Spillover in terms of capturing my attention. But this wasn't a bad book. Just felt a little stale, which might just be a me-problem. I need a break from virus books. Particularly right now when they're more devastating than interesting. -
This is the second time I’ve read THE COMING PLAGUE, NEWLY EMERGING DISEASES IN A WORLD OUT OF BALANCE by Laurie Garrett. The first time I read it, in the late 1990s, it scared me. This time it scared me more.
I’m reminded of the line from Hamlet,
“There are more things in heaven and earth, Horatio,
Than are dreamt of in your philosophy,”
which I usually use in reference to the unexplainable. In this case, it’s the unknown dangers that have lurked around humanity for centuries but choose to expose themselves only when humankind encroaches too far, too fast.
As I write this, the world is on the brink of a pandemic. Right now it could go the way of the swine flu or Ebola. Or it might be the centennial return of the Spanish flu. I hope not.
Reading this book, published in 1995, in 2020, one appreciates Ms. Garrett’s insight and restraint. Neither hysterical nor polemic, it is for the most part not dated. Much of what Garrett wrote has come to pass in some form or another.
It’s a thick book, 600+ pages, but there is very little that is superfluous. Ms. Garrett has also published several related articles over the years, many in Foreign Affairs, that are worth reading if you’re interested in the topic but unwilling to commit to the book. -
Poorly researched.
I really wanted to like this book, and indeed, right up until I casually fact-checked a shocking number for an article I was writing, I was enjoying the depth of information about epidemiology. I'm a microbiology student who has been fascinated with parasitology and infectious disease for a very long time, so this seemed like it was right up my alley. And then I tripped over her facts - or rather, falsehoods. She claims, in the chapter "Microbe Magnets" that there were 500,000 deaths from Cholera in NYC in 1832. Wow… that's a horrifying number. Except it isn't true. There were about 250,000 people living in NYC that summer, and 3215 of them succumbed to the disease. I was able to check it from multiple sources in mere moments, with the magic of the internet at my fingertips, and although I know she wouldn't have had that in 1994, it is still an egregious error. Sadly, I'm done reading this book, and will look for other, more trustworthy efforts in the field. -
This is probably one of the most informative books I've ever read. Laurie Garrett's knowledge of public health issues, coupled with her keen ability to write in Lay Terms-- makes this somewhat dry (but necessary) information a whole lot more palatable. It's been 11 years since I originally read it, so time for another read.
-
This is the best book you can read about disease, and it was the best thing I read in library school. Seriously, all of library school. You can just imagine how many books you have to read for something called "library school."
Probably a more important read than ever, the Coming Plague talks quite a bit about Ebola, for one, and the different methods by which diseases can be fought, how difficult it is to eradicate a disease, and how often politics and science can't get on the same page.
Don't look at the number of pages. Just pick it up and start. I promise, you will not be bored. -
pretty good. certainly thorough. "epidemic" is tossed around pretty liberally -- if a fever burns out a south american village, does it make a sound? poor editing, with numerous phrases and sentences repeated verbatim and certain acronyms expanded not at all, on late use, or multiple times. i'd like to have seen more on the virology and suppression of HIV and fewer tedious pages of stats and prediction histories. worth reading, though.
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I read this when it came out -- and thought it was brilliant. It seems not to have aged much, judging by recent reviews.
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Bwahahahaha. I'll write a review for this one of these days. Read this in high school and it's remained on my shelves since. Recommended for people who think drowning in your own blood is strangely intriguing.
Don't read this if you're prone to hypochondria. Or have a tendency to google your symptoms.
Hemorrhagic fevers are awesome. -
Written by a UCSC graduate, this book covers all of the many ways our actions contribute to the spread of disease vectors. Fascinating, scary and informative.
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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 -
Laurie Garrett's book The Coming Plague: Newly Emerging Diseases in a World Out of Balance is nearly 20 years old but it offers very interesting background information about the first round of Ebola in Africa, plus important discussion of how diseases develop and spread. Garrett is now senior fellow for global health at the Council on Foreign Relations and a Pulitzer Prize winning science writer, as well as being an engaging writer.
I had read this book several years ago when doing research on some medical matter at a time when AIDS was still little understood by the public. The chapters on Ebola and Marburg diseases were fascinating. While much has changed since, the account gives some idea of how diseases emerged out of nowhere and then receded after less than a year.
What is puzzling is that the diseases seemed to burn themselves out. This does not seem to be happening here, possibly because the outbreaks began in more densely populated, better connected parts of Africa than during the 25 previous episodes of the disease. (For an interesting comment see: Ebola: The Tolling Bell.) When people incubating the virus can travel, the risk of them contaminating others is great. In earlier epidemics, Ebola appears to have been confined to relatively isolated villages and once everyone in contracted the disease and either died or survived and became immune, the outbreak was over.
This time around, Garrett has some concrete ideas of how to stop the disease now that it's escaped African villages. In her trenchant piece Foreign Policy published Oct. 6, 2014, dhe writes: "First, a rapid point-of-care diagnostic that can find Ebola virus in a single droplet of blood must be developed. A point-of-care test avoids the need to ship samples to a laboratory and then wait for days to learn the results....I suggest the use of self-administered implements commonly used by diabetics to make a finger prick and squeeze out a droplet of blood. That droplet would go into a tiny plastic well -- an object about an inch in size that is internally coated with either DNA or antibodies that recognize specific genes or proteins found exclusively in the Ebola virus. If those viral markers are present, the device would glow with bioluminescence or change color -- the result would be observable with the naked eye...
"Finger-prick tests for Ebola are in development now at Senova, a company in Weimar, Germany; at a small Colorado company called Corgenix; and at California-based Theranos...One of these screening tests should soon meet the criteria of speed, accuracy, and ease of use necessary to prevent travelers' spread of Ebola; facilitate contact tracing; and, in the midst of the epidemic, tell who has the virus and who does not." -
There is a lot of amazing information in this huge tome, and it took me three weeks to get through, but it was worth it. It could have used a firmer editing hand though. Both the chronology of infectious diseases and the diseases themselves were divided into chapters in ways I failed to understand. Additionally, given the large amount of extremely useful information provided by this book, it would have moved the book along to edit down every individual thought every patient and every doctor ever had, every description of every little leaf in the jungle the disease emerged. I could basically write an entire book review about any chapter, it's so overwhelming.
There was a lot of information about AIDS provided in the second half of the book.
Some of the themes of the book are sleuthing the origins of novel pathogen outbreaks, scientific hubris, and illness containment fails.
I recently watched an interview with Dr. Ian Crozier, an Ebola survivor, and I was amazed at how much I understood that I'd only just learned from the information in this book.
I read this for some insight into the novel virus outbreaks like our cures coronavirus outbreak but I definitely gained a great deal more from reading this. And what a great ending! -
My husband got this one for me when he was TDY to Boston years ago. It is right up my alley in what I like to read. I would like to have been a microbiologist. If you are also interested in microbes you will enjoy this book.
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I'll first say: this book is LONG. Having it on my Kindle meant that I did not really understand how long this book would be. It is definitely a commitment.
Overall, it is terrifying. I would become a germophobe and start covering myself in anti-microbial hand sanitizers, but the germs will just evolve around it, become resistance, and kill me anyway. The best portions on this book are following the disease detectives from the CDC and other organizations as they investigated real-world outbreaks in the field. In this respect, the book was similar to
Beating Back the Devil: On the Front Lines with the Disease Detectives of the Epidemic Intelligence Service, and to a lesser extent
The Hot Zone: A Terrifying True Story, and
The Demon in the Freezer. However, I would say this book was more sophisticated and written a higher level (not for mass market readership) than those three. This is not a bad thing, as it was still very readable and not overly technical.
Where the book did drag was some sections on disease outbreaks, especially where it go too much in to statistics. Several pages seemed to blur together as it seemed to just be statistic after statistic on multiple drug resistant tuberculosis. Absent the drama of following disease hunters in the field as they searched for the source of Machupo, Lassa, Ebola, Hanta, and other deadly disease outbreaks, this book seemed to drag significantly, making the 700+ page length seem unbearable.
This book probably could have improved in this area, and one other, which would have been an updated edition that included more contemporary outbreaks, including the 2001 anthrax attacks, SARS, bird flu, and salmonella.
