Abstract
This book arrives close on the heels of the Ebola outbreak in West Africa. In its pages, journalist and widely acclaimed author Sonia Shah provides a comprehensive overview of the subject of pandemics, from a variety of disciplinary angles. In recent years, a surge of public interest has taken place surrounding deadly infectious diseases with pandemic potential, with a hefty assortment of newly published volumes of popular fiction and non-fiction alike to prove it. This is in fact Shah’s second book on pandemics; her most recent work—The Fever—being a widely praised work on the social history of malaria.
The current volume will appeal to scholars in medical and social sciences looking for a wide, yet lively and approachable, discussion of pandemics. Shah gracefully weaves together a wealth of information in just over 200 pages. The book should also appeal to general audiences with interest in infectious diseases and basic familiarity with medical terminology. Readers with a critical or social justice orientation, and a fascination with the lengths of human folly, will be energized by her social commentary. A fascination with the grotesque, or at least a strong stomach, will also be an asset. It can be a little heavy on the shock factor, but what else could one expect from a book whose binding screams the word “pandemic” in large block letters?
Altogether, the book provides a multidimensional analysis of pandemics, their causes and conditions, as well as the historical drama of our often botched attempts at finding cures. In the first chapter, Shah describes the “jump” of pathogens as they cross over from nonhuman to human infestation. In the following three chapters, she outlines various humanly created conditions that have and continue to be favorable toward the spread of deadly infectious diseases. She describes the increase and speed of transportation and human mobility, unsanitary—saturated with excreta—living conditions, and high-density human populations. In the next three chapters, she narrates the extent to which human attempts at overcoming pandemic diseases have all too often faltered and even backfired. Public health efforts are deflected and deflated by private interests. Kneejerk popular reactions and scapegoating are not only unproductive and socially damaging but also end up fueling the spread of disease. New scientific discoveries are held back from productive application, due to the investment that established scientific professionals have in their prior conclusions and ossified medical paradigms. In chapter 8, she goes on to explain how climate change will continue to contribute to the global danger in coming years. Zoonotic diseases tend to cross over to humans from creatures that thrive in warmer climates such as mosquitoes, ticks, and bats. And cholera—the pandemic illness that occupies center stage in Shah’s book—is caused by bacteria that thrive in warmer waters.
In this style of writing, a good author will know how to strike a balance between entertainment and rigor. For the most part, Shah pulls it off, which is saying a lot for a book that is so littered with bold imagery. There are times, however, where it feels like her claims are exaggerated, which is perhaps clearest in chapter 9. Here, she cites recent biological theories, which suggest that sex, senescence, and gender differences may have evolved as genetic defenses against pathogens, which she analytically fuses with pandemics. While hypothetically any pathogen could grow to pandemic levels, her equation of the two seems far-fetched. Admittedly, the notion of the “pandemic” is compelling in its dramatic flair. It can be so compelling that, even when she ties it tightly to evolution, death, and immortality, it is tempting to swallow her colorful claims at least for argument’s sake. At this point, “pandemic” becomes an empty signifier. How seriously should we take to connections she draws here? It is difficult to say. But, without question they make for an exciting and memorable read.
Overall, “exciting,” “memorable,” and also “panoramic” seem apt words to describe this book. It gives a comprehensive view of grisly, although critically important phenomena. It also provides a trenchant critique of social injustice. It should appeal to an educated lay audience as well as to medical and social science specialists.