The Premonition: A Pandemic Story By Michael Lewis

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This is a book about scientists and public health officials who rely on trained intuition. In a system ill-equipped to act nimbly in a pandemic landscape, they are the people that speak to what needs to be done now, not in a month or more when there are more cases and deaths. These characters are the system disrupters of public health in America. You may not agree with all of their conclusions and actions, but this is the best book Lewis has written in years. A fantastic narrative nonfiction that I highly recommend. Nonfiction, Business - Despite the White House spin attempts, this will go down as a colossal failure of the public health system of this country. The biggest challenge in a century and we let the country down. The public health texts of the future will use this as a lesson on how not to handle an infectious disease pandemic.

- We know what the virus will do, she liked to say. We don't know what the humans will do.

- We are the bad example for the rest of the world.

True, this book was not as informative as The Fifth Risk: Undoing Democracy, because - let's face it - if you're reading this, you've lived through a year and a half of the Covid crisis, and you already know a lot of the information covered. And, in some ways, this title picks up the gist of Lewis's last book which was indeed a warning to Trump, and all future presidents - If you don't know what a particular agency actually does then don't be in such a hurry to cut off funding for it!

We begin during the Bush administration, when George W. read a book about the 1918 flu epidemic. He became greatly concerned about the possibility of another killer pandemic, and a preparedness plan was put into place. (This is just one of the many reasons why it's important to have a president who READS!) By the time the Obama administration rolled around, there was a White House unit in place to detect and prevent biological, chemical, and nuclear threats to Americans and assist the states in various medical emergencies. The unit employed nearly two hundred people. The Trump administration had it busted up, so when there was a threat, they were clueless as to how to deal with Covid. Downplaying, then denying the disease's existence seemed to be their main strategy.

So how exactly do you find something that you refuse to look for because you believe it can't be there?

It was left to the states to control the disease. Some of them stepped up to the challenge admirably. Others failed miserably. But through it all, there were heroes quietly toiling behind the scenes.

It's often individuals who pick up the baton, and they're not even doing it as part of their day job description, said Joe. Scattered throughout those organizations there are these people, but they aren't organized, trying to compensate for the deficiencies in the system.

Lewis's book celebrates these underpaid and underpraised individuals, doctors and scientists, who had the sense to notice what was happening before their very eyes, and the courage to try to do something about it while our government did not. Let's hope they're all still around when the next pandemic hits.

A disturbing, discouraging, and very necessary read.

One day some historian will look back and say how remarkable it was that these strange folk who called themselves Americans ever governed themselves at all given how they went about it. Nonfiction, Business Fascinating insider story of how COVID-19 was mishandled by the US government, the CDC, and the WHO. Michael Lewis's tactic that has worked in his past books (Moneyball, The Big Short) worked great with Dr Charity Dean and others - he went deep into the character of this health worker from Santa Barbara, and through her told the story of ineptitude. My only criticism is I think he could have focused more on the global picture, as it was not just every state in the US fighting this thing differently, it was (and is) every country in the world. Maybe that would be good for a sequel...

Hilarious by the way that Charity Dean started in Santa Barbara, and the book describes her visiting the old age home where my grandmother lives!

One of the big things that at this point is lost on many of us, is that in ~Jan 2020, there was a chance to lock down quick on the virus and contain it. And because of the total lack of leadership, that chance was lost. This book describes how the Bush administration (I had thought it was Obama, but nope), had even put into place a plan, which had a lot of research behind it, for how to handle this very thing. But it was dismantled by the Trump and the CDC.

The greatest trick the CDC ever pulled was convincing the world containment wasn’t possible,” she said. “Our dignity was lost in not even trying to contain it.

We also had no shot at containment because we were not fast to have tests. We could have been had there been leadership prioritizing that, but there wasn't. This was really where we lost the game.

The absence of federal leadership, combined with the fragmented nature of the American health care system, meant that tests for the virus either weren’t available or were being processed too slowly to be of any use. Joe read stories of people waiting ten days for test results from Labcorp and Quest Diagnostics, two of the country’s biggest private labs.

The pattern continued right through the pandemic: the Trump administration would claim with fanfare that supplies were on their way to the states and leave it to the career civil servants whose job was to interact with state officials to reap the humiliation when those supplies failed to arrive. It would happen again with ventilators, with the drug Remdesivir, and, finally, with vaccines.


I found this quote very interesting - I wonder how the world will react to this? I would bet many countries will now stockpile and/or build in country manufacturing, though that doesn't seem like it should be the answer. Though in country manufacturing for the vaccine has certainly mattered.

Here is the frightening aspect of the global supply chain,” said Joe. “When there is a surge in demand, inventory goes to zero. Just-in-time manufacturing. Great concept! Horrible in a pandemic.

The scariest thing perhaps is that all the root causes that contributed to this happening have largely not been addressed. Nonfiction, Business Lewis has written an historical account of pandemic planning in the United States through the administrations of Bush, Obama and Trump. It ends up being a scathing indictment of the Centers for Disease Control and Prevention. The author highlights the shortcomings of the United States’ health system when facing a pandemic. By not having a centralized national health care system, the U.S. was not able to quickly put in place a pandemic response. [There was a modest-sized pandemic response unit put in place by the Bush administration, but was disbanded by 2020.]

Lewis focuses on the stories of a group of medical doctors and scientists who persevered to get the US to take the pandemic response seriously. This group of heroes were brilliant, dedicated, resourceful and conscientious. They understood all too well how unprepared America was to fight a pandemic. There was Charity Dean, a deputy director of California’s Department of Public Health. There were Richard Hatchett and Carter Mecher who had helped to shape pandemic planning in the George W. Bush administration, and worked tirelessly to mitigate the unfolding catastrophe. Lewis points to Joe DeRisi who developed an extremely useful technology for rapid viral testing—but was thwarted by institutional recalcitrance; and Bob Glass, a scientist whose 13-year-old daughter’s science fair project became the basis for the ‘social distancing’ model of disease control.

The irony is that institutions, like the CDC, that pursue an abundance of caution in the face of a pandemic amounts to a form of recklessness. More lives are lost. More lives damaged by the ravages of the disease. Highly recommend this fascinating account.
Nonfiction, Business Read this Book!
Most of us have many questions about the ongoing Covid pandemic. This book provides the context for most of those questions and raises a few questions of its own; particularly about the Centers for Disease Control and how they saw their roles and responsibilities.

Just as Americans were being repatriated from Wuhan, the government decided to only test those who were running a fever, even though other countries including Japan had already proved that a certain percentage of those infected did not manifest any fever: Did they want to avoid finding cases to avoid displeasing Donald Trump? Were they concerned that, if they tested people without symptoms and they found the virus, they’d make a mockery of their current requirement that only people with symptoms be tested? Were they embarrassed or concerned that someone other than the CDC was doing the testing? If so, then why didn’t they just perform the tests themselves? Thus, all Americans returning from Wuhan and were isolated, if they had no fever, were not tested before being released.

Here's how Lewis frames his focus: During the first half of the Trump administration I’d written a book, The Fifth Risk, that framed the federal government as a manager of a portfolio of existential risks: natural disasters, nuclear weapons, financial panics, hostile foreigners, energy security, food security, and on and on and on. The federal government wasn’t just this faceless gray mass of two million people. Nor was it some well-coordinated deep state seeking to subvert the will of the people. It was a collection of experts, among them some real heroes, whom we neglected and abused at our peril. Yet we’d been neglecting and abusing them for more than a generation.

Some writers of non-fiction have a special gift of serving you an immense bowl of ideas and facts without making you gag on all of it. Tracy Kidder and John Krakauer are two of my favorites and Michael Lewis fits in nicely with them. Here, he acquaints readers with some of the people that you never heard about, but whose efforts were key to understanding and responding to this pandemic. I have to give this book my highest recommendation. 5*

Some of my favorite insights from this book:
In February 2021, The Lancet published a long critique of the U.S. pandemic performance. By then 450,000 Americans had died. The Lancet pointed out that if the COVID death rate in the United States had simply tracked the average of the other six G7 nations, 180,000 of those people would still be alive. “Missing Americans,” they called them. But why stop there? Before the pandemic, a panel of public-health experts had judged the United States to be more prepared for a pandemic than other G7 nations. In a war with a virus, we were not expected merely to fare as well as other rich countries. We were expected to win.

Some of that blame was not due to political machinations but to governmental structure. Lewis calls out the Center for Disease Control (CDC) and its view of own role: The CDC had lots of great people, but it was at heart a massive university. “A peacetime institution in a wartime environment,” Carter called it. Its people were good at figuring out precisely what had happened, but by the time they’d done it, the fighting was over. They had no interest in or aptitude for the sort of clairvoyance that was needed at the start of a pandemic.

“All science is modeling. In all science you are abstracting from nature. The question is: is it a useful abstraction.” Useful, to Bob Glass, meant: Does it help solve a problem?

“The cost of a single TB case is between thirty and a hundred thousand dollars,” she said. “Higher if it is drug-resistant TB. So why are we haggling over a seventy-two-thousand-dollar machine?”

The decisions she was forced to make were less like, say, those made by a card counter at a blackjack table, and more like the ones made by a platoon leader in combat. She never had all the data she wanted or needed when making her decisions—enough so that afterward she could defend them by saying, “I just did what the numbers told me to do.”

If models could improve predictions about some basketball player’s value in a game, there was no reason they couldn’t do the same for the value of some new strategy in a pandemic.

He didn’t ask his superiors at Sandia National Labs for permission, because he already knew the answer. “They kill people for doing that,” he said. “They would flip and put people in between me and them, and I wouldn’t be able to do anything.”

Richard couldn’t understand his certainty, or the weird conventional wisdom that had coalesced. “One thing that’s inarguably true is that if you got everyone and locked each of them in their own room and didn’t let them talk to anyone, you would not have any disease,” he said. “The question was can you do anything in the real world.” The new models of disease, slow and unwieldy though they were, gave Richard hope. D.A. Henderson, and the people at the CDC, along with pretty much everyone else in the public-health sector, thought that the models had nothing to offer; but they were missing the point. They, too, used models. They, too, depended on abstractions to inform their judgments. Those abstractions just happened to be inside their heads. Experts took the models in their minds as the essence of reality, but the biggest difference between their models and the ones inside the computer was that their models were less explicit and harder to check. Experts made all sorts of assumptions about the world, just as computer models did, but those assumptions were invisible. And there was every day fresh evidence that the models inside the minds of experts could be seriously flawed.

The more Carter and Richard learned, the more excited they became. “Imagine if we could affect the weather,” Carter wrote, in one of his long memos. “Imagine if we had the capability to reduce a category 5 storm to a category 2 or a 1 . . . Now although the Federal Government is not at the threshold of significantly reducing the potency of a hurricane, it is at the threshold of doing just this to another natural disaster—pandemic influenza.”

He’d visited the CDC to explain the new genomic technology, only to be met with boredom and blank stares. In the Food and Drug Administration there was one woman—a single human being—trying to curate the academic literature so that doctors and patients could easily access new knowledge. She’d taken it upon herself; no one had asked her to do it. “It’s often individuals who pick up the baton, and they’re not even doing it as part of their day job description,” said Joe. “Scattered throughout those organizations there are these people, but they aren’t organized, trying to compensate for the deficiencies in the system.” The Red Phone could save your life if you called it in time. The system had configured itself in such a way that, more often than not, you didn’t.

To inject a virus into an African python took some trouble. Snakes don’t have injectable veins. They do, perhaps surprisingly, have hearts, and that’s where the virus must be injected. Snake hearts don’t stay put, like human hearts, but travel up and down the snake’s body. To inject a snake’s heart with a virus requires two postdocs and one full professor: one to hold the snake in a death grip, one to use a Doppler radar to find the snake’s heart, and a third to plunge the needle into it.

All of which was part of a bigger problem that he wanted to tackle: how any big government agency allocates its resources. Nonfiction, Business

This has been on my bookshelf for a couple of months, and I picked it up this week because I wanted a reliable read. Something I could be pretty sure I would find worth my time.

And wow, was it ever! I've been a Michael Lewis fan going all the back to his first book, Liar's Poker, and this is one of his best. The topic is timely (sadly, we are still still in a pandemic) and a question lingering in the air is, How could our response to this crisis have fallen so miserably short of the mark?

Lewis provides an answer, at least in part, by using his gift for dissecting a complex situation and turning it into a comprehensible story. As he so often does, he achieves this by introducing us to individuals who have personal insights into the problem that result in their becoming involved at some level. The people he features in this book come across as heroes who struggle to overcome systemic hurdles - and landmines - in hopes of saving lives from the worst ravages of the looming pandemic.

The institutions in this book by and large come off less well. From an organization dedicated to responding to public health crises in real time, the CDC has devolved over the past 40 years into, in the words of one of the heroes, the Center for Disease Observation. Ronald Reagan gave it a strong push in that direction by politicizing the top role.

George W. Bush, by contrast, is presented as a hero. After reading a book about the 1918 flu, he became convinced that the country needed a pandemic response, and set about establishing one that was pretty much shelved at the end of his administration. Obama didn't carry that torch as much as he should have, but made an attempt to learn from what happened with the CDC's swine flu response debacle in 1976 in order to be better prepared for the next round.

But it was Donald Trump's administration - particularly John Bolton in his role as National Security Adviser - who was responsible for completely derailing the potential for an organized response, when he determined that the only threats to the national security came from outside the country.

And so it came to people working outside any official framework to try to pull together a response to COVID 19. They spent much of their time crying in the wilderness, as their efforts to gain the attention of persons in the position of power or leadership were ignored. Their stories inspired in me both admiration for their efforts and sympathy for the frustration they experienced at every turn.

At the end of the day the book is a more detailed view of the sorry - and scary - condition of the US government that Lewis describes in broader strokes in The Fifth Risk: Undoing Democracy. In the hands of a less talented author it would be a hard message to digest. We can only hope that because Lewis makes his message so accessible, some of those people in positions of power or leadership will read the book, and learn something from it. Nonfiction, Business Click here to hear my thoughts on this book over on my Booktube channel, abookolive.


There are going to be a lot of pandemic books coming out in the coming months, but this is one that tells a story that was not exactly mainstream in 2020. In this book, Michael Lewis (in his typical fashion) talks about a small group of people who worked in or around public health and who had ideas about how to respond to the growing COVID threat, but really struggled to be heard. Like Lewis always seems to achieve, he takes a story we've all just lived through and turns it into a page-turning thriller. Nonfiction, Business I absolutely looked forward to reading this book after reading Lewis' The Fifth Risk. It was spooky to read in that book, published in 2018, that The basic role of government is to keep us safe and one of the potential disasters on the list is an airborne virus wiping out millions of people (page 25).

UPDATE
Not quite what I expected but still deeply informative. There was more background of handling a pandemic than I expected and less blame given to Trump. Nonfiction, Business Michael Lewis held my attention in this riveting account about how the US met the threat of Covid19, a virus that made 2020 the most challenging year that many of us had ever faced. This book gave me an inside look into ways in which our healthcare system failed in the most difficult crisis they had faced since the 1918 flu epidemic. However, Lewis also documents many valiant men and women who faced the crisis head-on, with courage and intelligence. Unfortunately, many of them met with bureaucratic roadblocks that stymied their progress.

It was worth reading the book just to gain a more complete understanding of the role of the CDC during the pandemic. What I gathered made me conclude that the CDC is excellent for after-the-fact studies and data collecting, but as foot soldiers on the frontlines in a war with a disease, there were huge deficiencies. Lewis includes some of the history of the CDC, back to the resignation of CDC Director David Sencer in 1976 after a debacle over the swine flu vaccine. This helped me understand why the CDC is the way it is and the need for brave people who are not yes-people to lead this vital institution. Currently, the Director is a Presidential appointee. Lewis seems to think it operated better when the Director rose through the ranks and was put forward by colleagues.

It was thanks to President George W. Bush, in 2005, reading The Great Influenza: The Story of the Deadliest Pandemic in History by John M. Barry, a story about the 1918 flu epidemic, that the US had a pandemic plan at all. It drove President Bush bonkers that there was as he put it, no “whole-of-society plan.” Congress agreed to allocate $7.1 billion to President Bush for pandemic strategy. The story of the team put together by Rajeev Venkayya, special assistant to the US President for biodefense, makes for fascinating reading. Physicians Richard Hatchett and Carter Mecher were two members of the seven-person team. Mecher had an incredible ability to think outside the box, and became invested in the accounts of Philadelphia during the 1918 flu epidemic. Others had concluded that infection control and social distancing were ineffective due to what had happened in Philadelphia but Mecher realized that Philadelphia’s actions were too little too late. Timing was of the essence.

Michael Lewis is also the author of ‘The Blind Side’ and ‘The Big Short’ and other books. He has a very natural storytelling ability that is engaging. There are many side stories in this book, but they connect to the whole in satisfying ways. For example, the exponential growth potential of the most transmissible viruses, Hatchett and Mecher, compared to the Mann Gulch fire in Montana in 1949. Fifteen fire-fighting young men parachuted into the area, hiking down into Mann Gulch with packs and axes. They believed the fire burned on the other side of the creek that they were hiking toward. When they neared the river, they were horrified to find the fire had jumped the river and was moving toward them at a terrifying speed. Ten of the men burned to death that day, two more would die later from their injuries. Carter was transfixed by what one of the men, Wag Dodge, had done to survive. He had lit a second fire. “As his fire burned the grass in front of him, he walked into it and threw himself onto the hot ashes...Dodge alone heard and felt the main fire passing by on either side of him, leaving him unscathed.” Carter related this to a pandemic, and came to several conclusions, one of them being, “You cannot wait for the smoke to clear; once you can see things clearly it is already too late,” and another, Figure out the equivalent of an escape fire.
Nonfiction, Business Still not prepared for the next one....

https://www.theatlantic.com/health/ar...

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This book is not going to be ranked with the author’s best books, such as Moneyball and The Big Short, but it was interesting nevertheless.

There’s a certain irony that Trump trolls and Libertarians have attacked this book, when Trump is hardly mentioned and the main villain is the CDC, a villain you’d think these critics would approve of. The book is also pretty tough on Democratic California Governor, Gavin Newsom. Of course, this would mean actually reading the book to find this out, which I doubt most of the trolls did.

What’s different is that Lewis conveys an element of advocacy and even anger you don’t see in his other books. I do hope the history books get it right about how the U.S. response was botched.

The watchword for these diseases is “early detection, early response.” Containing these diseases in their infancy is critical.

You may recall that at some point Mike Pence was put in charge of the Covid effort, which showed that Trump didn’t take it seriously. Pence's solution was to have prayer meetings.

Going back to the Reagan era, the head of the CDC had become a political appointee. Pence, an Evangelical, favored hiring Evangelicals which in this case included Deborah Bix and Robert Redfield. Both showed some serious lapses of judgment.

For example, after Covid broke out in China, numerous Americans flew home from there. Redfield was urged to test these folks when they arrived with a possible quarantine, but he refused, saying he was not going to treat them as “prisoners.” So they were free to blend into the general population and spread the disease.

For all his criticisms of public health agencies, Lewis should have included a section on how grossly underfunded public health is in the U.S.

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Excellent, more detailed review of the book....

“There is no incentive to prevent things,” Lewis says. “If you look at what our two societies have in common, we’ve given ourselves over to markets in a way that’s pretty extreme. Which is to say, we strongly encourage things that pay and we give correspondingly less attention to things that don’t pay. Prevention does not pay. Disease pays. It pays when Covid is all over society and corporations get to make a lot of money testing for it. It doesn’t pay just to shut it down up front. And if there’s food for thought, it’s that we were essentially incentivised to have a bad pandemic response.”

https://www.motherjones.com/politics/...

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Nonfiction, Business

For those who could read between the lines, the censored news out of China was terrifying. But the president insisted there was nothing to worry about.

Fortunately, we are still a nation of skeptics. Fortunately, there are those among us who study pandemics and are willing to look unflinchingly at worst-case scenarios. Michael Lewis’s taut and brilliant nonfiction thriller pits a band of medical visionaries against the wall of ignorance that was the official response of the Trump administration to the outbreak of COVID-19.

The characters you will meet in these pages are as fascinating as they are unexpected. A thirteen-year-old girl’s science project on transmission of an airborne pathogen develops into a very grown-up model of disease control. A local public-health officer uses her worm’s-eye view to see what the CDC misses, and reveals great truths about American society. A secret team of dissenting doctors, nicknamed the Wolverines, has everything necessary to fight the pandemic: brilliant backgrounds, world-class labs, prior experience with the pandemic scares of bird flu and swine flu…everything, that is, except official permission to implement their work.

Michael Lewis is not shy about calling these people heroes for their refusal to follow directives that they know to be based on misinformation and bad science. Even the internet, as crucial as it is to their exchange of ideas, poses a risk to them. They never know for sure who else might be listening in. The Premonition: A Pandemic Story