Pandemic- a book review

If you like history, current events, medical science, or just want to be more knowledgeable about why we should be concerned about infections , antibiotic resistance and vaccine phobia, you should read this book.

update July 25, 2020

When I read and reviewed this book almost 4 years ago, I thought it was only for historical interest. I never imagined you and I would live during and hopefully through a pandemic. I now know that assumption was false; this COVID-19 pandemic is not over, and even when it is, it likely will not be the last.

The world has now spent the majority of this year dealing with a COVID-19 pandemic producing grim statistics.

  • Almost 16 million confirmed cases world wide
  • 640,000 deaths worldwide
  • 4 million cases in the United States
  • Close to 150,000 deaths in the United States
source: Johns Hopkins Coronavirus Resource Center

Pandemic by Sonia Shah

Sonia Shah is a science journalist, not a scientist or physician, who has built a career  writing about medical science. She explains the “what”  of her book in the subtitle-

Tracking contagions from cholera, to Ebola, and beyond

And she answers the “why” in the introduction-

“By telling the stories of new pathogens through the lens of a historical pandemic, I could show both how new pathogens emerge and spread, and how a pathogen that had used the same pathways had already caused a pandemic.”

What is a pandemic?

Let me back up and define some terms. (And tell you this post uses affiliate links for your convenience and to fund this blog’s mission)

Pathogen– any disease producing agent, but especially referring to a living  microscopic organism, such as a virus, bacteria, or  parasite; this includes the organisms that cause Lyme disease, Ebola, West Nile, HIV, bird flu, even the common cold

Pandemic– a disease outbreak that spreads throughout a country, continent, or the world, as opposed to an epidemic, which is localized.

map of the world
In a pandemic, an infectious disease may spread all around the world.

With current focus on chronic diseases like heart disease, diabetes, cancer, and dementia, physicians and patients can get lulled into thinking that infectious disease has been conquered and no long a serious medical threat. This book reminded me that is not the case.

Cholera- a historic pandemic

Ms. Shah recounts the history of cholera, which has caused epidemics on every continent except Antarctica, focussing on the epidemics which devastated London, New York City, and more recently Haiti.

Cholera is little known in the United States now, but in the past it has been deadly both here and throughout the world. Cholera, an infection due to a bacteria Vibrio cholerae causes severe uncontrollable diarrhea which quickly renders its victims helpless, dehydrated and critically ill. The bacteria lives in and is spread by contaminated water, but for many years physicians did not know this; and even when some doctors proposed this as the method of spread, others refused to believe it. Thus the opportunity to control it and prevent thousands of deaths was delayed .

bacteria under the microscope
photo of the Vibrio cholera bacteria under a microscope; used courtesy of CDC/ Dr. William A. Clark
How pandemics spread

The author explains how cholera and other infectious diseases cause so much human suffering by detailing “How disease spreads” in these  chapter titles

Locomotion– Humans and pathogens travelling from place to place spreads disease.

Filth-Waste management and in some cases mis-management, leads to contamination of drinking water by human waste.

Crowds-People living in crowded slums creates perfect conditions to spread disease person to person.

Corruption– Public officials and business people who place profit and power above public health.

Blame No one willing to take responsibility for making hard choices, and too willing to blame someone else.

Ms. Shah uses examples from her personal life, like her annual family trips to India to visit relatives who lived in less than clean and sanitary neighborhoods. She also shares her and her sons’ battle with skin infections due to  MRSA, a form of staph (staphylococcal) that is resistant to many antibiotics and can be difficult to eradicate.

Pandemic includes extensive footnotes and a glossary of terms used in the book.

If you like history, current events, medical science, or just want to be more knowledgeable about why we should be concerned about infections , antibiotic resistance and vaccine phobia, you should read this book.

Other resources that address  the risk of global spread of infections.

For a visual lesson on how pandemics occur, watch this video.Warning: it is rather graphic. 

“How Pandemics Spread”
created by Mark Honigsbaum and animated by Patrick Blower 
When Germs Travel: Six major epidemics that have invaded America since 1900 and the fears they have unleashed
by Howard Markel

“Medical historian and pediatrician Howard Markel, author of Quarantine! tells the story of six epidemics that broke out during the two great waves of immigration to the United States—from 1880 through 1924, and from 1965 to the present—and shows how federal legislation closed the gates to newcomers for almost forty-one years out of fear that these new people would alter the social, political, economic, and even genetic face of the nation.”  (quote from Goodreads)

Dr. Larry Brilliant talks pandemics

Lawrence “Larry” Brilliant is an American epidemiologist, technologist, philanthropist, and author, notable for his 1973 – 1976 work with the World Health Organization, helping to successfully eradicate smallpox.

In this recent TED interview, he discusses COVID-19 , how we’re doing so far, where we’re going, and what we should do to get there

a book by Dr. Brilliant

Sometimes Brilliant: The Impossible Adventure of a Spiritual Seeker and Visionary Physician Who Helped Conquer the Worst Disease in History

Exploring the HEART of pandemics

Dr. Aletha
before you leave, take a look at this post

Why COVID-19 and other infections are not “just a virus”

Unless you haven’t listened to any news for the past 8 weeks, you are well aware of the “challenge” the whole world has been confronting over what some do call “just a virus”; and you know that it has caused much critical illness and death, leading to “public” and private anxiety.

6 things you need to know to get through the flu season

Read about the 6 things here at this updated version.

Head into the flu season with these 6 tips

We should all take influenza and COVID-19 seriously; consider my suggestions, talk to your personal doctor, keep up with recommendations from your local public health professionals, and do your part to keep your family and community well.

Keep reading

This is usually the busiest time of the year in physician offices, urgent care clinics, emergency rooms and hospitals. This information may make this season easier for you and for your doctor.

1. If you think you have the “flu”, you probably don’t. 

To many people “the flu” is any respiratory illness characterized by  fever, cough, congestion, fatigue and aches. That term has become so nonspecific even we doctors use it that way. But flu refers to influenza,  one of many viruses that cause illness. The other viral illnesses  are “colds”, upper respiratory infections, aka URIs, bronchitis, pharyngitis, sinusitis and pneumonia.

The human respiratory system
The respiratory tract including the nose, sinuses, mouth, throat, trachea, bronchi in blue and the lungs (pink). Infections can involve the breathing organs from the nose all the way down to the lungs. (photo complimentary from Pixabay)
  1. If your doctor thinks you have “the flu”, you probably do.

Prior to the  “rapid flu” test, we doctors diagnosed influenza by the characteristic symptoms,  exam, and knowing there was an outbreak in the community. The test is helpful for confirmation and patients have come to expect it now.

3. The best way to prevent influenza is by vaccination.

The World Health Organization (WHO), Centers for Disease Control and Prevention(CDC) , the National Foundation for Infectious Disease and  other reputable medical organizations recommend vaccination against influenza.

People refuse vaccination because they believe it is ineffective, unnecessary, dangerous, toxic, unnatural, subversive, and who knows what else.  I don’t think I or anyone else are going to change their minds.

My family and I always get vaccinations which have successfully protected us without side effects or adverse reactions. There are risks, just like there are with any medical procedure, or lots of other things we do in life. In this case we have decided the benefit outweighs the risk.

If you don’t want a “flu shot”, your doctor may ask you why. You may have heard misinformation that she can discuss with you.

  1. If you want to avoid getting influenza, avoid being around people who may be infected.

This means everyone, since one may be contagious 2 to 3 days before symptoms. It’s not a coincidence that influenza outbreaks coincide with the American holiday season (approximately November through January). So to protect us all,

  • Stay home if you are sick, and ask your family, co-workers and employees to do the same.
  • Cover your nose and mouth when coughing or sneezing
  • Wash your hands frequently.
  • Wash frequently touched surfaces frequently.
Hand hygiene saves lives.
a common sight now in public restrooms
  1. If you do get sick, don’t ask your doctor for an antibiotic.It will not help. 

    Antibiotics attack bacteria. Influenza and 99% of all respiratory illnesses are due to viruses.

There are 2 antiviral drugs that will “shorten the duration and severity of symptoms” by 1-2 days, if started early. The effectiveness is uncertain for an illness that will resolve within 10-14 days regardless. But if it gets you back to school or work a day earlier, it may be worth the cost-they are not cheap drugs.

Otherwise, the treatment is“symptomatic” or “supportive” care:

  • Rest; eat and drink as normally as possible; extra fluids if running a fever 
  • Non-prescription cough/congestion /pain/fever meds

Here are  general guidelines  on what to do if you get a respiratory illness.

  1. You can die from influenza, but you probably won’t.

I cringed last year when a friend wrote on her social media page, “My doctor said, ‘No one dies of the flu’.”That is not correct. People die from complications of influenza, and infants, young children and the elderly have greatest risk.The most common fatal complication is bacterial pneumonia, infection in the lung. Influenza can also attack the nervous system causing brain inflammation (encephalitis and/or meningitis) and paralysis in the form of Guillain Barre syndrome .

an xray of healthy lungs with no signs of pneumonia.
Healthy lungs with no signs of pneumonia.

Persons with chronic illnesses like diabetes, lung disorders, depressed immune systems and cancer are at greater risk of complications and should always consult a physician if feeling ill. If you are not sure if you fall into that category, ask your doctor.

Influenza is a disease to take seriously; consider my suggestions, talk to your doctor, and stay healthy this season.

Here are some other posts about winter illness you may find helpful.

Get Smart About Antibiotics

6 smart facts about antibiotics

Sorting out sinusitis