The Wisdom of Plagues: Lessons from 25 Years of Covering Pandemics

by Donald G. Mcneil Jr.

Award-winning New York Times reporter Donald G. McNeil, Jr. reflects on twenty-five years of covering pandemics—how governments react to them, how the media covers them, how they are exploited, and what we can do to prepare for the next one—in this “fascinating, ferocious fusillade against humanity’s two deadliest disease and itself” (The Economist).

For millions of Americans, Donald G. McNeil, Jr. was a comforting voice when the COVID-19 pandemic broke out. He was a regular reporter on The New York Times’s popular podcast The Daily and told listeners early on to prepare for the worst. He’d covered public health for twenty-five years and quickly realized that an obscure virus in Wuhan, China, was destined to grow into a global pandemic rivaling the 1918 Spanish flu. Because of his clear advice, a generation of Times readers knew the risk was real but that they might be spared by taking the right precautions. Because of his prescient work, The New York Times won the 2021 Pulitzer Gold Medal for Public Service.

The Wisdom of Plagues is “must-reading for preparing us better for the next unavoidable epidemic” (Peter Piot, MD, co-discoverer of Ebola) as McNeil shares his account of what he learned over a quarter-century of reporting in over sixty counties. Many science reporters understand the basics of diseases—from how a virus works to what goes into making a vaccine. But very few understand the psychology of how small outbreaks turn into pandemics, why people refuse to believe they’re at risk, or why they reject protective measures like quarantine or vaccines. The COVID-19 pandemic was the story McNeil had trained his whole life to cover. His expertise and breadth of sources let him make many accurate predictions in 2020 about the course that a deadly new virus would take and how different countries would respond.

By the time McNeil wrote his last New York Times stories, he had not lost his compassion—but he had grown far more stone-hearted about how governments should react. He had witnessed enough disasters and read enough history to realize that while every epidemic is different, failure was the one constant. Small case-clusters ballooned into catastrophe because weak leaders became mired in denial. Citizens refused to make even minor sacrifices for the common good. They were encouraged in that by money-hungry entrepreneurs and power-hungry populists. Science was ignored, obvious truths were denied, and the innocent too often died. In The Wisdom of Plagues, “one of the most enlightening books on public health” (Lena Wen, MD), McNeil offers tough, prescriptive advice on what we can do to improve global health and be better prepared for the inevitable next pandemic.

Genres: Nonfiction, History, Science, Health, Medicine, Audiobook, Politics

Audible Audio

Published January 9, 2024

Reviews

[Sarah-Hope · Rating 4 out of 5]

Donald G. Mcneil, Jr., is a retired reporter who spent the bulk of his career focusing on issues of global health. The Wisdom of Plagues is his attempt to pull together clear, accurate accounts of some of the global health crises he's witnessed and to explain the lessons he hopes we will learn from them so that we can face future health crises more productively.

In particular, he wrestles repeatedly with the question of individual rights/freedoms vs. the common good. One example he uses is the difference between the handling of AIDS in the U.S. and its handling in Cuba. He argues [this will be controversial, so prepare yourselves] that Cuba, which systematized mass testing and required the relocation of those testing positive for AIDS to dedicated health facilities, did a better job of responding to the epidemic than the U.S., which insisted on only voluntary testing and no tracking of individuals who tested positive. In the case of COVID-19, he compares the disjointed responses across the U.S. to China's quick ability to "lock down" cities and/or regions where the virus was present.

What he's calling for is a more systematic and rigid public health system that is empowered to require things of the public—like masking or being vaccinated. In fact, he argues that the U.S. public health system should be as powerful and well-funded as the pentagon, given that it is a crucial part of national security.

I have a great deal of empathy for his concerns. Wearing masks protects others more effectively that it protects the individuals actually wearing the masks, which is one of the reasons I saw the anti-mask fervor in the U.S. as a demonstration of how little we care for others in our community. Individuals felt their right to avoid the discomfort of masking outweighed the possibility that they could be infecting others, particularly if they were asymptomatic carries. But I also understand the other side of the equation. In California during the AIDS epidemic, we had a ballot proposal that would have registered and potentially quarantined people with AIDS.

Perhaps the lesson is that anything, even if we believe it's "right," can be weaponized.

I received a free electronic reviw copy of this title from the publisher via NetGalley; the opinions are my own.

[Sofia · Rating 3 out of 5]

A solid read! I think what I most enjoyed about this book was the author's pursuit of truth, and his thoughts on individual freedoms vs community health when it comes to pandemics. Although the author was much more insistent on societal health at the expense of individual freedoms (to a point I thought was extreme at times), I found that this pushed me to reflect quite deeply on the matter. The examination of the media's role in fostering fear or calm was also something I enjoyed a lot.

Overall, the author very much believes that lives always had more value than rights and it's a viewpoint that I respected, while sometimes not being convinced. He has had a really interesting career, and I love books written by journalists.

Still, I think the book felt flat at times - abounding with personal reflections, jumping around, and the ending felt quite sudden to me and not super natural.

I would still recommend this for anyone who likes reading about health policy, pandemics, and the history of disease control.

[Jamie Park · Rating 5 out of 5]

I had to read this in bits and pieces because it starts out with a personal recap of the first days of covid. I had just received my Consumer Health Information Specialist certification to go with my masters degree so I was heavily invested and terrified in the early days ( I am still terrified).
Although I did like the few weeks of fake lockdown we had here in town. People stayed home, more or less, and we all relaxed for a few weeks. I could do that part again. Now everyone who hasn't died has had it multiple times and we are seeing long term issues, not to mention our immune systems are destroyed. I will add that I got it for the first time while reading this amazing book.
Anyway, so in the beginning the author recalls warning people and people not listening.
I just felt that in my soul.
The book then dives into the history of pandemics and why we have them. It is so good. There were bout 90 lines in this book that I want to plaster all over the internet and the city. It is brilliant.

[Ben · Rating 5 out of 5]

Outstanding Read

Donald is an incredible researcher and journalist. I was thoroughly glued to the pages in this book - hard to put down!

Outstanding analysis on pandemics and plagues of the past, but also... the current.

I found it extremely fascinating, and timely too, as it is filled with a particular critical and important eye on how COVID was handled.

Definitely recommend reading this one!

Recommended Reading
I also recommend reading this along side these books:
Spillover: Animal Infections and the Next Human Pandemic
Pathogenesis: A History of the World in Eight Plagues
Deadly Quiet City: True Stories from Wuhan
Wuhan Diary: Dispatches from a Quarantined City
What Really Happened in Wuhan: The Cover-Ups, the Conspiracies and the Classified Research
Made in China: Wuhan, Covid and the Quest for Biotech Supremacy

4.8/5

[Neill Bates · Rating 4 out of 5]

4.4 ✴️

[Malaika · Rating 2 out of 5]

The author almost gets the point. He talks a lot about corruption in the global South. But instead of inquiring why it happens he just says it should be fought. He does not realise that the exploitation by the global north of the global south is far more wide reaching and insidious. The amount of money especially African countries which were previously colonized are cheated out of due to contracts they were forced to agree makes any corruption seem insignificant.
I also think that you cannot cover the Covid pandemic without at least shortly mentioning long Covid and other long term lasting effects after Covid. Like organ, brain and vascular damage. I mean this book was published in 2024, there were hundreds of scientific articles about this at that point.
He puts everything down to vaccines and while vaccines are great and lifesaving, but with Covid the most important thing is to stop the spread. It has been shown time and time again. Covid attacks the immune system directly. Is dysregulates both innate and adaptive immunity. Which means that it impacts both immune system you’re born with and the immune system which adapts to your circumstances (ie past infections). So even if you vaccinate your immune system can ‘forget’ what it has learned from the vaccine after multiple infections. Vaccines can reduce fatality rates and are thus very important, but avoiding repeat infections should be the main goal.
The other thing which irritated me was that he constantly talks about Africa as if it is one country. He sometimes does mention South Africa specifically, but at the end he mentions again that he lived in Africa. Africa is a huge continent with many different countries and cultures, can we please start naming them and acknowledging this? We are in 2025 for gods sake.

[Kalyan · Rating 5 out of 5]

One of the amazing, well-researched, and well-narrated books I have read. It started with COVID, and I thought it was going to be boring and repetitive, but I was mistaken. Donald drove the point home: healthcare needs to be prioritized, and diseases are not given the attention they deserve. In one chapter, he mentions that politicians did a better job than scientists, which I found interesting. I believe politicians don't receive the credit they deserve. To me, they are the engine oil of a large, complex democratic machine.

I liked the book—it exceeded my expectations. I listened to the audiobook version, and the narrator's voice and modulation were excellent. Oh, I almost forgot! This book also emphasizes the importance of journalism, journalists, and media organizations. I realized that being a journalist, doing the job thoroughly, and getting it published is an incredibly tough field. Kudos to all the journalists who continue to do their jobs despite the pressures they face. All in all, it’s a good book to listen to.

Don you did a good job of writing this book, much appreciated.

[Ashley Denktas · Rating 5 out of 5]

This is a 4.5 stars for me. I wasn't expecting to be as engrossed in this book as I was. It provided really amazing accounts of several pandemics and how trends for how the most prevalent diseases have spread. I think what really set this book apart from others is its recommendations on how we can stop the spread of disease. Regardless of borders we need to make preventative measures a top priority and be willing to enact policy and effects that will prevent the lost of life. Mcneil's proposals made sense and aim to protect all regardless of political affiliation. I think I will find myself coming back to this book to fully be able to recall the facts and recommendations in it.

I think one of the most interesting recommendations was "respecting witch doctors." It lends itself to meeting people and their local customs and empowering leaders who are trusted in communities to help prevent the spread of disease by teaming up and working with doctors part of westernized medicine institutions.

This book was a good read but also depressing, as we have the ability to eradicate the spread of several diseases and keep the most vulnerable alive right now - we as a society just choose not to or adamantly reject science as fact.

[Cory · Rating 4 out of 5]

Too wise for the world

4/5

As a front line medical worker during COVID-19, I saw much of what Donald Mcneil discusses in this book firsthand. Despite advance notice, everything was reactionary -- there was no budget, no PPE, no additional protection or planning for our safety as workers, as people. To compound the frustration, the politics of the US consistently undermined the severity of our struggle.

Mcneil explores these elements not just nationally in the US, but globally. Politics often conflict with science & medicine, but perhaps more prominently, religion is the most adversarial. Religious exemptions have become quite common in the US in opposition to vaccine mandates, which has compromised herd immunity for many major diseases like measles. In western Africa, Christian fundamentalism has created distrust in vaccines & the medical community as a whole.

Perhaps most damaging in the present pandemic, is the mistrust/loss of expertise. Scientists who have spent 20+ years specializing in diseases were discredited by the president, which led to public mistrust & disregard for scientific advisories like masking. The lasting impact of this is still being felt in the US, as few still regard COVID-19 as a problem, likening it to "a bad flu" (which is most assuredly is NOT).

While perhaps controversial, Mcneil's opinions on the need for a "Pandemic Pentagon" resonated with me. Why is it so important to have military command but not scientific command in this age of antibiotic resistance & potent zoonotic diseases? And yet this new administration (2025) is intent on dissolving foreign aid, money for science & arts, & shrinking the govt footprint while enriching the oligarchs who truly rule America.

Likes
+ Lots of anecdotal accounts from global pandemic investigation & response
+ Good use of scientific/medical data
+ Informed opinions/recommendations for further pandemic response change from a knowledgeable source
+ Great use of historical data to frame present day struggles
+ Valuable insight into the obscure, mysterious origins of COVID-19

Dislikes
- Perhaps too critical of non-Western countries' responses given limited resources & oppression
- IMO: too sparse of exploration in some compelling areas vs. too repetitive/detailed in others (personal preference I think)

Summarily, I recommend this book to anyone in medicine, science, & anyone interested in community well-being. Frankly, we should all have this in common: care for human life & preventing catastrophic loss when avoidable. Mcneil's book not only offers insights into how humans continue to fail miserably at this, but also offers pragmatic solutions that could alter pandemic response for the better.

[Kimberly Pinzon · Rating 4 out of 5]

This was a really informative book without using language beyond a layperson's ability to understand. The only reason why it isn't a five star rating is because the author's ego and "I-know-best" attitude crops up often. There is also some internal inconsistencies, for example where he writes that it's reasonable to not believe China's COVID numbers, but then turns around and holds them up as an example of what America should have done from the beginning of the pandemic. So which is it? Is China trustworthy or not?

Other than those things, this was a very worthwhile read.

[Madeleine · Rating 5 out of 5]

Full of super interesting perspectives on pandemics that I’d never before considered! For example, I’d never thought about the balance of protecting personal freedoms vs saving lives by focusing on public health. I also liked that the author had such a definitive argumentative position on these subjects. Overall I feel like I learned so much, and I always wanted to go back to this book (atypical for non-fiction, which I usually have to push myself to pick up)!

[Magen · Rating 4 out of 5]

There was so much interesting and new information in this book. While it was certainly a little difficult to read, feeling like I was thrust back into those early days of the pandemic filled with uncertainty and confusion, many things were put into perspective. The information is presented very well, factually and understandable. An informative read and important for perspective.

Thank you to NetGalley and Simon & Schuster for the eARC in exchange for an honest review.

[Alejandro González · Rating 5 out of 5]

¿Quién lo diría? La ignorancia, corrupción política y la religión son en resumen el 90% de la causa de que todo sea peor.

Excelente libro sobre como se desarrollan las pandemias gracias a un conjunto de todo lo mencionado en mi primer párrafo, pero desmenuzado para que lo disfruten como quien ve un accidente en cámara lenta.

[Greg Peterson · Rating 3 out of 5]

I learned a lot about disease in general. This was helpful.

[Barbara · Rating 4 out of 5]

4.5 stars



Author Donald G. McNeil Jr.

Donald G. McNeil Jr. was a New York Times science and health reporter for twenty-five years. In that time, McNeil became an expert on pandemics, and he shares his insights in this book. The treatise is divided into four parts: Initial Reflections on Pandemics; The Tangled Roots of Pandemics; The Human Factors That Spread Pandemics; and Some Ways to Head Off Future Pandemics.

🧬 Initial Reflections on Pandemics

Since it's so recent, the Covid pandemic is well-known around the globe. Many plagues have come and gone, however, most of which are not in the world's collective consciousness. McNeil is more conversant with global contagions than most, his first 'up close' experience being in Johannesburg, South Africa in 1998, at an orphanage full of HIV-positive children doomed to die.


South African AIDS Orphanage

Triple-therapy antiretroviral cocktails for HIV were available, but they were expensive, and South Africa couldn't afford them. There were negotiations and patent wars and so on, and in time, pharmaceutical companies were (essentially) pressured into selling the drugs to poor countries for reduced prices. McNeil observes, "The world was changing its attitude toward the dying poor." This is important for many reasons, one being that - in our interconnected world - ANY reservoir for contagious diseases is a potential threat to everyone.



🧬 The Tangled Roots of Pandemics

McNeil believes the United States badly mishandled the Covid pandemic. To assess how we dealt with the virus, McNeil compares America to two countries that match us in culture, per capita income, public health expertise, and risk factors. The two countries are Canada and Germany.

By 2023, as the pandemic wound down, the United States had suffered almost twice the per capita death rate of Germany and almost three times that of Canada. McNeil attributes this to poor leadership. He notes that "German chancellor Angela Merkel and Canadian prime minister Justin Trudeau took the threat seriously from day one and worked hard to get their populations to accept social distancing, business closures, and masks." However, in the United States, "We had denialism, finger-pointing, and polarization, much of it coming from the top."


Angela Merkel


Justin Trudeau

Another recent pandemic, less well known, is the monkeypox (Mpox) outbreak that lasted from spring 2022 to spring 2023. The illness affects gay men, and though it's not usually lethal, Mpox can result in intense pain, secondary infections, and scars.

McNeil observes, "One would imagine that, having just survived [the Covid] pandemic....we would have reacted judiciously to the new one.....since we already had two vaccines that could stop [Mpox]." Instead our response was disappointingly slow - this time because Mpox was a 'gay disease.'


Patient with Mpox

McNeil writes, "[The CDC's] chief concern seemed to be to damp down alarm and to avoid stigmatizing gay men by avoiding any mention of the fact that almost all the new victims were male and gay." In short, the authorities feared they'd be accused of gay bashing. McNeil feels it's imperative that public health leaders "get over their squeamishness and fears of criticism; they must directly address whoever is at highest risk and counsel them on how to protect themselves."

At one time, the major factors affecting life on Earth were phenomena like asteroid strikes, volcanic eruptions, atmospheric heating, glaciation, plate tectonics, etc. In prehistoric times, these types of events caused five major extinctions. Now that humans have come to dominate the planet, disease is shaping our destiny. McNeil states, "Pandemics have had more impact than any earthquake or eruption, any new weapon or infantry tactic, any new religion or political system."

Pandemics began with the establishment of human settlements, when people started living in close proximity, farming, and domesticating animals.


Early human settlement

The author notes, "We stored our new abundance of food in granaries, attracting rats, mice, and other disease-spreading rodents. We dug cisterns for fresh water, pits for sewage, and dumps for our food waste. That helped mosquitoes, flies and other disease-spreading insects adopt us as new hosts....We sneezed in each other's faces, defecated in each other's drinking water, and slept with each other's spouses. We opened pathways for animal bacteria, viruses, worms, parasites, and fungi to spread among us."

Most pandemics originate when animals pass their microbes to us; these illnesses are called zoonotic diseases. Zoonotic diseases happen more and more as we invade animals' territories - or get close to them - because of human population growth, deforestation, bushmeat hunting, factory farming, live animal markets (wet markets), and so on.



Unfortunately, new disease threats are evolving all the time; no pandemic will be our last; and what will matter is how intelligently and fast we respond.

🧬 The Human Factors That Spread Pandemics

Once a new disease appears, many factors affect its dissemination and the number of people infected. A major stumbling block for pandemic control is the fact that most pathogens first appear in a small network of similar people. The ideal time to stop the pandemic would be now, at the very beginning, before it spreads.


Pandemics start with a small group of people infected

However, public health officials are in a difficult position because these 'patient zero' networks are often composed of one ethnic or marginalized group - like gay men, the homeless, ultra-Orthodox Jews, or Amish farmers. Thus health officials trumpeting the threat are liable to be accused of bigotry.

McNeil observes that the 'blame' issue comes up in almost every outbreak. The most famous example is syphilis, which first appeared in the army of Charles VIII of France in 1495. The author writes that the French called it the Neapolitan curse; the English, Italians, and Germans called it the French Pox; the Russians called it the Polish disease; the Turks called it the Christian disease; the Japanese called it the Chinese pox; and so on.

Any group can end up being blamed for spreading disease, and in modern times, condemnation has fallen on Jews (measles, polio); Chinese people (bubonic plague); Mexicans (swine flu); homeless people and drug abusers (tuberculosis); college students and Alpine skiers (Covid); and more.

By definition, pandemics don't remain local, and 'superspreader events disperse contagions far and wide. For instance, smallpox has spread during the Hajj (Islamic pilgrimage to Mecca); Covid spread during India's Hindu festival of the Kumbh Mela; and flu spread during World Youth Day (a gathering for young Roman Catholics).


Smallpox spread during the Hajj


Covid spread during India's festival of the Kumbh Mela


The flu spread during World Youth Day

The best way to contain a disease is to identify an outbreak as soon as it starts, and internet 'disease-alert services' report new contagions all the time. McNeil, who's a subscriber, observes, "I see new outbreaks reported from somewhere in the world almost every day.....[though] most are not terribly threatening."

Many outbreaks begin with a pattern of unexplained deaths in remote areas that fly under the radar until the illness reaches a city. For instance, between 1976 and 2012, there were 17 Ebola outbreaks in Africa, none of which killed more than 300 people. In 2014, the virus reached the capitals of Liberia, Sierra Leone, and Guinea, and killed 11,000 victims.



There are a number of disease alert services, such as the Global Outbreak Alert and Response Network; FluTrackers; ProMed and others. Some services are better then others, and all would be more useful if medical personnel and public health officials consulted them regularly.



Another problem with disease control is the (attempted) cover-up. For instance, in 2003 Beijing lied about a SARS (Severe Acute Respiratory Syndrome) outbreak in Guangdong, which eventually infected about 8,000 people in 29 countries; and in 2012, Saudi Arabia covered up a MERS (Middle East Respiratory Syndrome) outbreak, which spread to more than a dozen countries.


SARS outbreak in China


MERS outbreak in Saudi Arabia

McNeil goes on to write about disease spread fueled by denialism - people who think the threat's not real or that it won't happen to them; and fatalism - the refusal to save oneself by getting vaccinated. Fatalism is sometimes connected with religious beliefs. For instance, some Muslims denied the polio vaccine, leaving their fate in Allah's hands; and in India, devout Hindus refused smallpox vaccine because they feared angering the smallpox goddess Shitala Mara.


The smallpox goddess Shitala Mara

Worse yet, antivaxxers sometimes mount campaigns purely for profit. McNeil opines, "The modern anti-vaccine lobby....portrays itself as a movement of concerned parents but is really an industry underwritten by unscrupulous entrepreneurs." Some antivaxxers profit by selling immune enhancing vitamins; some promote homeopathy, chelation, hyperbaric chambers, etc.; and some sell books and quack cures. Sadly, the antivaxxers cost many lives during the Covid pandemic.


Antivaxxer Larry Cook

🧬 Some Ways to Head Off Future Pandemics

McNeil observes that America's most lethal pandemic in a century, namely Covid, was so bad because no one was in charge. All manner of people weighed in, including the president, directors of various health agencies, the U.S. surgeon general, FDA commissioners, cabinet members, medical professionals, and more. But there was no one 'at the top.'

To defuse future pandemics, the author advocates a clear chain of command; a 'health pentagon'; tougher public health laws; and a better prepared society. McNeil also emphasizes the need to fight global poverty; derail the anti-vaccine lobby; deny religious exemptions for vaccination; and improve surveillance.

The author also supports working with 'witch doctors', who are respected and influential in their cultures; and curtailing civil liberties when they impede disease control. This would include things like mandating masks, enforcing social distancing, shutting businesses, closing borders, curtailing large gatherings, and so on.


Witch doctors are respected and influential in their cultures


Pandemic control might include curtailing people's civil liberties

McNeil has done an immense amount of research and cites myriad examples for his observations and opinions. The narrative is a little repetitive, but anyone interested in epidemics, pandemics, and the fight to stop them would find valuable information in this book.

You can follow my reviews at https://reviewsbybarbsaffer.blogspot.com

[Lucas · Rating 4 out of 5]

For how bold this book is in its statements, I actually absolutely adore this. The perspective being given by the uthor, self-admittedly radical, in the name of public health, are extremely interesting to here, especially when coming from one who has been dealing with such threats for 25 years.

It's hard for me to choose just a single aspect of this book I enjoyed particularly as the whole thing was very enjoyable, and written from a point of view that cannot be undervalued, and really contributes towards the ideas, humorously, though honestly presented, by the author.

4.5/5. Very good book.

[David Blankenship · Rating 5 out of 5]

This book was fascinating to me on a very personal level. In March 2020 I took my family on a once-in-a-lifetime spring break vacation to England, where we spent 10 days. In the weeks leading up to it, the news of the COVID-19 pandemic crept closer and closer to us. And all along, we wondered, should we cancel our trip? Or should we assume that this was another overblown story that wouldn't really affect our trip? We really didn't know what to believe, but earnestly wanted to think that everything was going to be OK. We landed in London on Friday, March 13 (which I believe was the day in which England finally was made it onto the travel advisory list), and while the first few days were mostly normal (except for the canceled soccer match we were going to attend), by the following Tuesday almost everything had shut down...museums, restaurants, most of those things we wanted to see. It was a surreal time, even more so being in a foreign country. We couldn't book an early flight home, so we piddled around in our rented houses for almost a week before finally making back to the United States. Upon arriving, we had to quarantine at home another two weeks before joining with our fellow Americans in the great Shutdown of that spring. We barely worked, saw almost nobody indoors, and were unable to worship at our church. We bided the time by watching TV, playing games, and enjoying the clean air as we wondered when things would return to Normal.

Now, almost four years later, COVID is still a thing. Close friends of mine have died, many others have been seriously ill, and we are as divided a nation as ever. A book like this would have been really good as mandatory reading in 2019, but of course it did not need to have been written yet.

Yet the underlying question of this book that the author asks is simply, "What did we learn?" Looking around and seeing the obstinancy and idiocy of so many people, it makes me think that we haven't learned a damn thing. In fact, some people are even more stubborn and scientifically challenged than before. I wish had known a lot of what the author mentions in this book, and hopefully after reading it I will use a bit more wisdom if ever a situation like this happens again.

Still, I want to recommend this to everyone I know. Especicially good in this book is section three, when the author gets into all the human factors that spread pandemics, such as denialism, rumor-mongering, and the profiteers and opportunists who see trouble as an opportunity to advance a toxic agenda. Looking back at the last four years, we saw those things especially with the MAGA movement of Trumpism, but also those on the Left whose ideological agenda may be thrwarted by common sense and real science.

I really do appreciate this book and hope that it gets a wider audience, but I fear that even as the pandemic continues to be a very real thing (and the next one is likely coming sometime in my lifetime), nobody wants to hear what is said.

[Nicky · Rating 5 out of 5]

This was a marvelous journey through Donald McNeil's 25 years of his OWN journey covering pandemics at the Times.. not just COVID, but H5N1, SARS, HIV as well as other epidemics. Also included are pandemic histories that stretch back to small pox and George Washington all the way to ancient times.

The book is divided into 4 distinct parts: initial reflections on pandemics, the tangled roots of pandemics, the human factors that spread pandemics, and some ways to head off future pandemics. My enthusiasm behind giving this book 5 stars is from the work that was put into the last two sections. Additionally, I really appreciated the notes in the rear of the book, which includes references to news reports, government briefs, and science publications.

As someone with biomedical scientific training, I feel like he was spot on in describing the personal strengths and weaknesses of scientists, physicians, and leaders in science. These are people who are largely driven to make conclusions based on data, and usually not keen on following instinct without the data to back it up. As such, it was especially fascinating for me to read about so many situations where a decision needed to be made based on instinct - sometimes with limited data, sometimes without - and the outcomes as it pertained to government policy, public health, and finances.

The way the book is written is fluid. Each chapter contains little tidbits from multiple diseases, disasters, or decisions. For example, HIV comes up many times throughout the book. It's not just one chapter and then move on to the next disease. One chapter may have stories of ebola, malaria, HIV, Covid, H5N1, Zika, and others. Likewise, the book is not specific to the United States and its policies. I appreciated that it wasn't partisan, especially as it pertained to HIV and COVID in the United States. GW Bush did good things, Trump did good things, Biden did good things. They all also did not so awesome things. I appreciate that even with more liberal leanings (both my own and Donald McNeils), no one political party was singled out as failures or saviors. So it's not really the type of book that should get too many people riled up. The content is largely fact driven (especially parts 1-3, part 4 is a bit of a thought exercise, but was an excellent read) and has his own personal experiences.

I am so glad I stumbled across this in the new releases of my local library.

[Victoria · Rating 3 out of 5]

What I Liked: Very informative. He has a lot of very interesting takes.

What I Didn't Like: His tone was at times a little arrogant.

[Susan Scribner · Rating 3 out of 5]

Not just another COVID 19 book; former New York Times science editor McNeil pulls back and discusses how the world has almost always botched its response to pandemics. He links these failures to a combination of factors: response time, denialism, bigotry, corruption, media coverage, political opportunism and profiteering. The book is non-partisan for the most part; McNeil assigns blame to both Trump and Biden for lives that were unnecessarily lost to COVID-19.

The book's first half is the most interesting; in the second half McNeil proposes solutions that have less than a snowball's chance in hell of being adopted. It's difficult not to insert himself into the narrative because McNeil reported from the front lines of many pandemics, including several that devastated other countries but left the US relatively unscathed. But he does have a superior "I alone know the answers" tone that becomes more grating in the how-to-fix-things chapters. Another pandemic in our lifetimes is likely; I am not optimistic we will react more productively than we did in 2020.

[Richard Derus · Rating 5 out of 5]

Real Rating: 4.75* of five

The Publisher Says: Award-winning New York Times reporter Donald G. McNeil, Jr. reflects on twenty-five years of covering pandemics—how governments react to them, how the media covers them, how they are exploited, and what we can do to prepare for the next one.

For millions of Americans, Donald McNeil was a comforting voice when the COVID-19 pandemic broke out. He was a regular reporter on The New York Times’s popular podcast The Daily and told listeners early on to prepare for the worst. He’d covered public health for twenty-five years and quickly realized that an obscure virus in Wuhan, China, was destined to grow into a global pandemic rivaling the 1918 Spanish flu. Because of his clear advice, a generation of Times readers knew the risk was real but that they might be spared by taking the right precautions. Because of his prescient work, The New York Times won the 2021 Pulitzer Gold Medal for Public Service.

The Wisdom of Plagues is his account of what he learned over a quarter-century of reporting in over sixty countries. Many science reporters understand the basics of diseases—how a virus works, for example, or what goes into making a vaccine. But very few understand the psychology of how small outbreaks turn into pandemics, why people refuse to believe they’re at risk, or why they reject protective measures like quarantine or vaccines. The COVID-19 pandemic was the story McNeil had trained his whole life to cover. His expertise and breadth of sources let him make many accurate predictions in 2020 about the course that a deadly new virus would take and how different countries would respond.

By the time McNeil wrote his last New York Times stories, he had not lost his compassion—but he had grown far more stone-hearted about how governments should react. He had witnessed enough disasters and read enough history to realize that while every epidemic is different, failure was the one constant. Small case-clusters ballooned into catastrophe because weak leaders became mired in denial. Citizens refused to make even minor sacrifices for the common good. They were encouraged in that by money-hungry entrepreneurs and power-hungry populists. Science was ignored, obvious truths were denied, and the innocent too often died. In The Wisdom of Plagues, McNeil offers tough, prescriptive advice on what we can do to improve global health and be better prepared for the inevitable next pandemic.

I RECEIVED A DRC FROM THE PUBLISHER VIA NETGALLEY. THANK YOU.

My Review: "The innocent too often died" in plagues...that is one of those evocative sentences that sound good until you start unpacking them. Does this excuse the public-health indifference around the fate of the incarcerated, as we presume them to be guilty? (Of what, and why, let’s leave for another book review.) Of course not...at least I hope those reading my reviews agree that this is not acceptable...but it illustrates a fact of the author’s writing such a book reveals.

How we talk about plagues, and public health in general, is deeply fraught and will, no matter how carefully phrased, offend and insult someone.

What Author McNeil chose to do with that realization was write the facts of plagues...origins, spreads, containments...in the context of a long career’s take-aways about what works, what doesnt, and how to effectively stop the inevitable rise of some highly infectious and contagious disease from becoming another pandemic. I tell you upfront, you will hate the answer. It involves infringing, to an astonishing degree, your liberties.

The author has covered the topic for an adult human lifetime. He has seen what effective responses look like. The US did not mount an effective response to COVID, and many died who need not have done. I live in an assisted-living facility with many, many smokers. Over thirty of the residents...out of two hundred-ish...died. Many, including me, got sick. Many of those, though not me, went to the hospital to treat their infections. We were lucky it was not a lot worse because the leaders locked us down, passed out masks like candy, made social-distancing rules that they enforced, and still people got infected.

But we live in a state where those measures were put in place quickly and enforced. Fewer died, and got seriously ill, because the patchwork of regulations and responses worked in our favor. That was good luck, which was in short global supply. But we live in a state where those measures were put in place quickly and enforced. Fewer died, and got seriously ill, because the patchwork of regulations and responses worked in our favor. That was good luck, which was in short global supply. There were even then other challenges concurrent with COVID, eg monkeypox, that never became pandemics despite having the makings of such. One big reason is the public-health response was faster, more openly communicated, and more united. This limited the pathogens’ natural ability to spread.

What the author says to us is that solipsistic selfish behavior in defense of your little "liberties" is fatal in the context of a pandemic. Sometimes Life is not fair, but to save the lives of others you must be ready and willing to accept the loss of unlimited, unrestricted personal "liberty." Sarcastic tone implied by quotes very much intended.

Author McNeil is a bona fide expert on this subject. He knows from being there what is needed to stop a pandemic from arising. I sometimes found his explications, deeply grounded and reported with clarity, to be repetitive, so can not offer a perfect five-star rating. I devoutly hope that some who did not read The Daily during 2022 will still find this book and respond to his "I was there, I saw it happen," account of pandemics past, and re-evaluate their stances on responding to the absolutely inevitable and guaranteed recurrence of a pandemic.

A boy can dream.

[Jerry Smith · Rating 5 out of 5]

There's a lot to like in this book that examines COVID, but in the far broader context of pandemics generally, which is a great lens through which to view it. I was very taken by the approach, especially as I picked this up as a cold read, thinking it was perhaps more about pandemics past, than the most recent example. However, I was not disappointed at all.

This is a very well written and approachable account that sheds light on how we manage such calamities, and it is usually pretty bad. As a species we are a panicky group who demand answers to questions for which such answers are unclear, we belittle folks who don't have the answers on our terms of reference and then run down epistemological methods that would most likely give us what we want, and we fail to learn lessons, again and again. However, what particularly struck me was the tone of the narrative. It was entirely reasonable. This is not a screed against anti-science people, although one would be justified in my opinion, nor is it a critique of politicians and leaders without qualification. Indeed, DMc does provide criticism where it is due (which is a lot) but also recognizes that the timeframes when decisions need to be made are different for leaders and sometimes they made the right, difficult, calls. This gives him a tremendous amount of credibility as an author and we should really listen to what he has to say.

Further, he does what I often criticize authors for not doing and that is recommend solutions. What we should do, but probably won't, next time. Because there will be a next time for sure. I admire the way he makes recommendations that would be very unpopular, and acknowledges that but argues for the greater good and the saving of lives. These are wide ranging and would require significant policy change and political will and they go beyond, but include, comments about lock downs etc. He discusses the importance of addressing poverty and unaffordable meds in developing countries where so many pandemics begin, addressing international pharm and the need for collaboration therein, increasing surveillance, working with local witch doctors and healers to identify patterns and trends and much more. Honestly, although we know much of this lacks political will, what's the point of trying to do something if one doesn't aim high. And what could be more important than protecting the globe from pestilence?

Really excellent contribution to the COVID literature which, whilst clearly taking a strong stance with which I agree, is very well argued in the context of other diseases such as HIV, monkeypox, TB and influenza. He avoids taking sides although is unafraid to pull his punches and seems to have an excellent grasp on human nature and some of our foibles. An unexpectedly good, and thought provoking read that I greatly enjoyed, and has me looking at things in a different way. These are the ultimate tests of a great non-fiction book for me.

[Annie · Rating 5 out of 5]

Originally posted on my blog Nonstop Reader.

The Wisdom of Plagues is an interesting layman accessible nonfiction monograph on his experiences in science reporting by Donald G. McNeil Jr. Released 9th Jan 2024 by Simon & Schuster, it's 384 pages and is available in hardcover, audio, and ebook formats. It's worth noting that the ebook format has a handy interactive table of contents as well as interactive links and references throughout. It makes it so easy to find information with the search function.

Although much the language of pandemics as well as most people's interactions and awareness of pandemics are inevitably tied to Covid-19 and the media and reporting of that specific occurrence, there have been many (many!) other contagions and Mr. McNeil does a good job of integrating sociology, media, awareness, and education in general as well as to his experience covering science beats for the last 25 years. There's quite a lot of introspection and supposition on the part of the author, a lot of "what if" and "how to use this knowlege", and "what could be in store?". It's illuminating to read. Coming from a science background, and understanding a lot more about the biological mechanics involved and quite little about humans and their herd psychology, very much of this info was completely new.

The book is divided into four distinct sections: initial reflections (how he got where he is), what if (covid, monkeypox, etc), human factors, rules and regulations and how they can mitigate and impact future pandemics (and if nothing else is set in stone, that fact is, that there *WILL* be a next time).

Although it's written in accessible and easy to understand language, it is rigorously annotated and the chapter notes and bibliography are likely worth the price of admission on their own merits.

Five stars. This would be a superlative choice for public and tertiary institutions of higher learning, home use, and for fans of popular scientific writing.

Disclosure: I received an ARC at no cost from the author/publisher for review purposes.

[Sara · Rating 4 out of 5]

I first remember encountering Don McNeil at the very beginning of the Covid pandemic when he started appearing on The Daily podcast. This was when it was unthinkable what was coming. I was desperate for a clear view of the future and McNeil’s predictions were always spot on, playing out just as he said they would. I came to really rely on his reporting, and then he was fired by the NYT for behavior on a trip with young people years earlier. I can see from his writing and descriptions of conversations he has with news room colleagues and others what got him in trouble. It’s too bad that some people who are brilliantly good at what they do don’t seem able to temper their egos or communicate with others in respectful ways. I know what it’s like to not feel heard on important topics but it’s not ok to abuse other people just to get your point across. That goes for everyone.

Regardless, I found McNeil’s insights into the reasons public health sometimes fails - regulatory capture, social taboos, political calculations, marginalization of affected people, magical thinking, and just plain denial - to be well outlined and illustrated. The book could have been a bit better organized around these topics - it jumped around a lot, constantly coming back to Covid, making the overall message a bit muddled.

McNeil admits to being an authoritarian when it comes to public health measures. His look at why different ideas about individual freedom and shared responsibility in different countries led to different policy approaches and responses by the public made it clear why that approach can’t be the only answer. I would love to see a sociologist and political scientist take a look at what WOULD work given the spectrum of cultural leanings around the world. One thing is true for sure: Communicable diseases are part of the human condition.

[Christopher Doyle · Rating 4 out of 5]

Drawing on his years of writing on health for the New York Times, Mcniel puts forward an excellent account of recent pandemics, and the successes and failures of public policy responses.

He provides a thorough analysis of the lessons from the Covid pandemic. The successes, (mNRA vaccines) and failures (politics, misinformation, government delays). Mcneil accurately points out that a country's success had little to do with authoritarian or democratic forms of government, but hinged on the population's level of trust in their healthcare system.

Many of his prescriptions for global health in the future are sound; better access to affordable medication, more money for research and preparedness, better global cooperation. He makes a compelling case for controversial vaccine mandates - pointing out that an individualist country like the US might not exist but for George Washington's decision to make smallpox vaccines mandatory for his military.

Other solutions seem to fall wider of the mark. His suggestions for a militarized CDC (complete with military uniforms!) and mandatory health checks for all citizens seem likely to only feed mistrust and would likely further erode trust in healthcare institutions.

Some of his more draconian proposals do not detract from the excellent overview of pandemics and public policy responses (or lack of). Indeed, they only highlight the challenges and tough choices future leaders will have to make in the next pandemic.

[Rahul Banala · Rating 5 out of 5]

It seems so bizarre that the combined trauma of COVID is never spoken about and is pushed under the rug in public consciousness. This book was a great reminder of how terribly we bungled that crisis. McNeil did a great job of bluntly speaking to our mistakes. The unproductive back and forth of health officials providing useful information, the lack of the federal government taking any responsibility to provide much needed resources to the states and forcing the states to fight each other for resources, the horribly flawed mask mandates that were undermined by soulless politicians. It was a stark reminder of how little individuals cared about each other especially in developed countries.
It was insightful hearing about the successful campaigns that other nations had even ones similar to the U.S. like Australia and New Zealand who were covid free long before us and had remarkably lower deaths. McNeil’s exploration of other diseases and public health concerns and how they were addressed really helped me learn about how effective responses to disease should be shaped and executed. Will it ever happen? I don’t know but I do share the author’s frustration in how politics and ideas of “personal liberty” in a time of pandemics can do irreparable damage both to the health and psyche of the people.

[Allie Farrell · Rating 4 out of 5]

The Wisdom of Plagues was written by Donald G. McNeil, who, until he retired, was the science writer for the New York Times. Much of his time, and his interest involved travel to remote parts of the earth studying the great plagues of the time - AIDS/HIV, SARS, MERS, Monkey Pox, Ebola, and of course COVID-19. What emerges in this book is coverage of the many reasons why diseases get out of control. Greedy pharmaceutical companies, unfit rulers, fear of vaccines and treatments, distrust of anything scientific. It was a fascinating book to listen to, and I definitely learned a lot about disease transmission, the efficacy of vaccines, and many other topics. I gave the book a 4/5 because I didn't like at all how preachy Mr. McNeil came towards the end of the book, and in the last chapter particularly. Although I agree with much of his ideas and what he would do differently, I didn't like his tone, his arrogance, or the way he looks down upon the average reader as uneducated and in need of his opinions.

[Lisa Davidson · Rating 5 out of 5]

I do read a lot of nonfiction books about diseases and most of them are from the point of view of medical professionals and/or scientists. This author has a journalistic background, so can provide a unique outlook on what he has witnessed in regards to how diseases have affected the world in recent times.
Unlike almost everyone else, McNeil predicted that Covid was going to be really bad. He got to watch in real time as so many factors went into play to cause an enormous number of unnecessary deaths in the US.
McNeil talks about other instances and diseases too, sharing details of the diseases themselves and how governments react. While he has advice on how to do better, it seems like such a huge amount of misinformation to overcome in order to protect people.
Thanks to NetGalley for letting me read this important book

[Sandra]

"He’d covered public health for twenty-five years and quickly realized that an obscure virus in Wuhan, China, was destined to grow into a global pandemic rivaling the 1918 Spanish flu."

"By the time McNeil wrote his last New York Times stories, he had not lost his compassion—but he had grown far more stone-hearted about how governments should react. He had witnessed enough disasters and read enough history to realize that while every epidemic is different, failure was the one constant. Small case-clusters ballooned into catastrophe because weak leaders became mired in denial. Citizens refused to make even minor sacrifices for the common good. They were encouraged in that by money-hungry entrepreneurs and power-hungry populists. Science was ignored, obvious truths were denied, and the innocent too often died."

Published in 2024. Good god.

[Amanda · Rating 4 out of 5]

I was really impressed by this book! I thought it would just cover COVID-19, but it actually goes into a lot of detail about different pandemics from the last 25 years. The author writes in a way that's easy to understand, even though sometimes there's a lot of information to take in all at once. What I really liked about this book is how the author shares their own thoughts and lessons learned from these pandemics, especially COVID-19. They talk about what could have been done better and what we should keep in mind for the future. This makes the book not just informative, but also really makes you think about what comes next. In short, this book is packed with useful information and insights. I'd definitely recommend it to anyone who wants to learn more about pandemics. I'm giving it 4 out of 5 stars for being such an eye-opening read.