We talk to Michael Lewis about his new book The Premonition, which tells the story of the people who saw the pandemic coming and asks why they couldn't get a hearing. It's a tale of short-term failures and long-term trends in US government and it follows on from his previous book about the risks America has been running in hollowing out the administrative state. A sobering account with glimmers of hope for the future. 

Talking Points: 

Old timers at the CDC say that things began to change after the 1976 swine flu outbreak.

• The CDC rushed a vaccine program, and some people got sick. Then the swine flu basically vanished.
• After that, under Reagan, the head of the CDC became an appointed, political job. This made the CDC overall more political and less independent. 
• Most people who interacted with the CDC before this pandemic realized that it wasn’t very good at managing disease.

Doing a public health job well carries a high risk of getting fired.

• The experts in Michael’s story are consistently right about the trajectory of the disease; but they are often wrong about politics.
• Should experts pay more attention to politics? 
• Experts can create discomfort for politicians, or they can give them cover—but that’s not their job. Michael thinks that politicians should be providing cover for the experts.

Why was it so hard to learn from the experiences of other cities in the heart of the crisis?

• In the 1918 pandemic, the difference between Philadelphia and St. Louis was the timing of the intervention. 
• It’s hard to see the effect of the interventions in the fog of battle.
• The failure of testing in the US at the start of the pandemic meant that there was no way to identify where the virus was.
• Just-in-time manufacturing and taut-supply changes made the ‘health industrial complex’ less able to respond quickly.
• Will the pandemic make Americans care more about how the government actually functions?

Mentioned in this Episode: 

• Michael’s new book, The Premonition, a Pandemic Story
• Richard Neustadt and Harvey V. Fineberg, The Swine Flu Affair
• The Nuclear Threat Initiative 2019 report
• Our last episode with Michael

Further Learning:

• David J. Spencer, ‘Reflections on the 1976 Swine Flu Vaccination Program’
• Lawrence Wright, ‘The Plague Year,’ The New Yorker
• How some cities ‘flattened the curve’ during the 1918 flu pandemic
• More on the San Quentin COVID epidemic

And as ever, recommended reading curated by our friends at the LRB can be found here: lrb.co.uk/talking

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