Covers the basics and current status of vaccines, Malaria, AIDS, Tuberculosis, HIV, Ebola, SARS, MERS, Zika, Influenza, antibiotics, Yellow Fever, Dengue, etc.
This book was written in 2017. Not only does it accurately predict many aspects of our current pandemic so far, but coronaviruses get several mentions. The most chilling parts are reading Osterholm’s warnings and possible future problems while living through an event that’s facing many of those same issues.
This is a book you'd wish all policymakers would read. It’s full of recommendations, step-by-step plans of action, orders of priority, and warnings about inaction. Many specialists are quoted throughout—Dr. Anthony Fauci makes a few appearances, mostly about eradicating influenza. I highly recommend this read. Until then, here's my note dump of relevant information from the book, posted from quarantine:
Severe acute respiratory syndrome-related coronavirus (SARSr-CoV) is a species of coronavirus that infects humans, bats and certain other mammals. This is the virus species containing SARS (SARS-CoV) and the current Coronavirus/COVID-19 (SARS-CoV-2). MERS (MERS-CoV) is a betacoronavirus similar to SARS.
Virus Stats (from the WHO and Johns Hopkins):
SARS Outbreak from 2002–2004:
8,098 cases, 774 deaths, 17 countries, 9.2% fatality rate
MERS (Middle East respiratory syndrome) from 2012–present (as of 1/31/20):
2,506+ cases, 862+ deaths, 26 countries, 34.4% fatality rate
COVID-19 from 2019–present (as of 3/23/20):
372,000+ cases, 16,000+ deaths, 194 countries, 4.4% fatality rate
[Everything below is directly from the book]
Origins of SARS and MERS:
SARS: "By May, it had been determined that two of the prime reservoirs for the disease were masked palm civets and ferret-badgers, native to the Guangdong, South China region and sold in local markets there as food. So the transmission to humans was probably similar to that of Ebola when locals in rural west-central Africa ate infected bushmeat. Further research indicated that the civets and badgers had most likely caught the virus from bats sometime in the months to years before the outbreak.”
MERS: "The original reservoir for the disease, as far as we can tell, is a bat species found in the Middle East. The bats then transmitted it to dromedary camels—the one-humped species common throughout the Middle East and North Africa. Recent studies have been conducted testing stored blood samples collected from camels in both Africa and the Arabian Peninsula for antibody to the MERS virus or a MERS-like virus. They found that these viruses have been circulating in camels in both areas for at least five years.”
SARS and Coronavirus in China:
"But Dr. Peter Daszak, a disease ecologist and president of EcoHealth Alliance, recently observed, 'SARS is alive and well and living in China, and ready for the next outbreak.'"
"Two recent studies support that [above] conclusion. Bats sampled in China and Taiwan were found to be carrying a coronavirus that was genetically almost identical to the SARS virus and that any day could be transmitted to another animal species that has substantial human contact. What happened in Guangdong Province in China in 2002 and 2003 could happen all over again if one of these bat viruses infects humans, most likely via another infected animal. We can’t for a moment believe that the SARS virus obituary has been written."
"Once we understood the natural history of SARS and coronavirus in wildlife and understood that bats were a likely reservoir, there was no logical reason to suppose that exterminating a bunch of civet cats and ferret-badgers would stop Mother Nature from throwing additional coronaviruses at us."
Coronavirus as a superspreader:
"For reasons we still don’t completely understand, certain individuals with coronavirus become ‘superspreaders’. In the public health–infectious disease world, we worry most about diseases that have high mortality rates and that can be effectively transmitted via the respiratory route—in other words, killer diseases that you can catch just by being in the same air space with an infected person or animal. Superspreaders break the reproductive rate rule. They transmit to many more contacts than other cases with the same infection. It’s unclear why superspreaders infect such a large number of those exposed. What we do know is that superspreaders can make coronavirus infections in humans into a very scary situation. These superspreaders are not obvious; they are not necessarily sicker, immunocompromised, older, or pregnant—all the conditions we normally associate with being more infectious."
On hospital PPE shortage:
"Guess what: We’re pretty much at capacity now under normal circumstances, having cut all of the 'fat' out of the system for budgetary reasons. We don’t have any surge capacity. We also will run out of the equipment we need to protect healthcare workers, such as respirators and the tight, face-fitting masks. Who will come to work if they realize they are substantially increasing their chances of catching influenza because of a lack of protective gear?"
"Here’s an even grimmer example. If 1% of those critical influenza victims need ventilators, we can probably handle it. If 3% need them, forget it; we just don’t have enough machines in the country, and neither does any other country. Even if they did, do you think they would lend them to us? That means a lot of people would die even though we have the technology to save them. We’d get into triage and issues of allocation and hard choices no one wants to confront."
On pandemics:
"We must realize and plan for the terrible impact a pandemic could have and all the deaths that would occur as a result of an acute shortage of lifesaving drugs or medical care. And it should matter greatly to us if a factory worker in China or India who is responsible for helping to manufacture these drugs is too sick to work or a freighter ship captain who is delivering them dies en route."
"In 1918 [Spanish flu], there were three distinct waves of disease over a two-year period, and that is what we could face again. So the only Hail Mary we would have is whatever we put in place beforehand."
A hypothetical scenario near the end of the book of a virus H7N9, an influenza infection called the “Shanghai flu”, hits so many aspects of our current pandemic. It’s worth the read alone.
Michael T. Osterholm, PhD, MPH is the director for CIDRAP (Center for Infectious Disease Research Policy) out of the University of Minnesota. In March 2020, he published the article Facing COVID-19 Reality (with this book’s coauthor) and did the Joe Rogan podcast.
