Pandemic, Sonia Shah's recent bookwith a long subtitle --
Tracking Contagions from Cholera to Ebola and Beyond - is a 288-page warning. This "Pandemic" title evokes fear in some and a shrug in others who see it as a historical footnote no longer applicable to modern society. Either response may prevent opening the cover. Those who make the fateful decision to begin reading soon find themselves entangled in a captivating page-turning thriller. The book opens up a world outside the vision and experience of most 21
st century Americans.
Even with my physician experience combating third-world infectious diseases,
the first three chapters left me saturated with anxiety about the future.
Shah sheds a light on the illusion that modern society is safe. Time diminishes the memory of the black plague, small pox and influenza that 100 years ago killed more than 500,000 Americans. A repeat performance, with today's population, would kill 10 million-that's more than the population of all but 7 states.
In fact, experts do anticipate a deadly pandemic this century, as well.
Which known or newly evolved pathogen will be the cause? That remains a mystery.
Shah exhaustively details past human successes and failures. She offers the hope that by unraveling the stories of past pandemics, and with better understanding of our relationships within the web of life across this beautiful orb, we might prevent or mitigate unimaginable human disease and death.
She argues that it's our thinking and metaphors that need to evolve:
"The reigning metaphor... is war. We 'attack' illness. We 'wage war' on disease. We 'arm' ourselves with medicines. ...we imagine ourselves as victors of a winnable war with pathogens."
That's a false bravado, lacking appreciation of our common and complex interaction. When conditions are right, it's a mathematical mismatch:
"...epidemics grow exponentially while our ability to respond proceeds linearly, at best."
While epidemics of "foreign Invaders" invoke fear, Shah emphasizes that there exists a parallel danger at the other end of the danger spectrum"
"Once [pathogens] cease to provoke fear, they have secured the golden ticket. They no longer have to mount our defenses because there is little public interest in defending ourselves."
Complacency is the first step toward a pathogen becoming entrenched in society and gaining endemic disease status. "Endemic diseases are arguably much worse than epidemic ones. They are harder to get rid of... and more burdensome, too, because they regularly sicken and kill year after year and not just in a single outburst."
To that end,
Pandemic should be required reading for anyone who holds public office or who works in public health or in health care. Both our individual and collective health depends on knowledge, while pathogens and pandemics feed on ignorance and corruption.
Our reactions to pathogens "range from futile paroxysms of fear to lethal apathy." It's time for sustained engagement where we "transcend the simplistic enemy/victor dichotomy and develop a new way of thinking about microbes and our role in the microbial world."
About the author
Dr. Scott Hamstra, pediatrician, Captain (retired), served Arizona Native American communities as a US Public Health Service Officer for 24 years before retiring from Active Duty in 2014. Since then as Medical Advisor to the STC Board, he shifted focus to expanding the impact of vaccination to the USA and world. While living in Tucson, he continues to provide medical care to Native Americans.
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