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Deadliest Enemy: Our War Against Killer Germs
A leading epidemiologist shares his "powerful and necessary" (Richard Preston, author of The Hot Zone ) stories from the front lines of our war on infectious diseases and explains how to prepare for global epidemics -- featuring a new preface on COVID-19.
Unlike natural disasters, whose destruction is concentrated in a limited area over a period of days, and illnesses, which have devastating effects but are limited to individuals and their families, infectious disease has the terrifying power to disrupt everyday life on a global scale, overwhelming public and private resources and bringing trade and transportation to a grinding halt.
In today's world, it's easier than ever to move people, animals, and materials around the planet, but the same advances that make modern infrastructure so efficient have made epidemics and even pandemics nearly inevitable. And as outbreaks of COVID-19, Ebola, MERS, and Zika have demonstrated, we are woefully underprepared to deal with the fallout. So what can -- and must -- we do in order to protect ourselves from mankind's deadliest enemy?
Drawing on the latest medical science, case studies, policy research, and hard-earned epidemiological lessons, Deadliest Enemy explores the resources and programs we need to develop if we are to keep ourselves safe from infectious disease. The authors show how we could wake up to a reality in which many antibiotics no longer cure, bioterror is a certainty, and the threat of a disastrous influenza or coronavirus pandemic looms ever larger. Only by understanding the challenges we face can we prevent the unthinkable from becoming the inevitable.
Deadliest Enemy is high scientific drama, a chronicle of medical mystery and discovery, a reality check, and a practical plan of action.
Unlike natural disasters, whose destruction is concentrated in a limited area over a period of days, and illnesses, which have devastating effects but are limited to individuals and their families, infectious disease has the terrifying power to disrupt everyday life on a global scale, overwhelming public and private resources and bringing trade and transportation to a grinding halt.
In today's world, it's easier than ever to move people, animals, and materials around the planet, but the same advances that make modern infrastructure so efficient have made epidemics and even pandemics nearly inevitable. And as outbreaks of COVID-19, Ebola, MERS, and Zika have demonstrated, we are woefully underprepared to deal with the fallout. So what can -- and must -- we do in order to protect ourselves from mankind's deadliest enemy?
Drawing on the latest medical science, case studies, policy research, and hard-earned epidemiological lessons, Deadliest Enemy explores the resources and programs we need to develop if we are to keep ourselves safe from infectious disease. The authors show how we could wake up to a reality in which many antibiotics no longer cure, bioterror is a certainty, and the threat of a disastrous influenza or coronavirus pandemic looms ever larger. Only by understanding the challenges we face can we prevent the unthinkable from becoming the inevitable.
Deadliest Enemy is high scientific drama, a chronicle of medical mystery and discovery, a reality check, and a practical plan of action.
368 pages, Paperback
First published March 14, 2017
1289 people are currently reading
6059 people want to read
About the author
Michael T. Osterholm
9 books90 followersMichael Thomas Osterholm (born March 10, 1953) is an American epidemiologist, regents professor, and director of the Center for Infectious Disease Research and Policy at the University of Minnesota.
Osterholm graduated from Luther College in 1975 with a B.A. in biology and political science. He received his M.S. and Ph.D. in environmental health and his M.P.H. in epidemiology from the University of Minnesota.
Osterholm has received honorary doctorates from Luther College and Des Moines University, and is a member of the Institute of Medicine of the National Academy of Sciences. His other honors include the Pumphandle Award from the Council of State and Territorial Epidemiologists; the Charles C. Shepard Science Award from the CDC; the Harvey W. Wiley Medal from the Food and Drug Administration; the Squibb Award from the Infectious Diseases Society of America; Distinguished University Teaching Professor, Environmental Health Sciences, School of Public Health, University of Minnesota; and the Wade Hampton Frost Leadership Award, American Public Health Association. He has also received six major research awards from the National Institutes of Health and the CDC.
Osterholm graduated from Luther College in 1975 with a B.A. in biology and political science. He received his M.S. and Ph.D. in environmental health and his M.P.H. in epidemiology from the University of Minnesota.
Osterholm has received honorary doctorates from Luther College and Des Moines University, and is a member of the Institute of Medicine of the National Academy of Sciences. His other honors include the Pumphandle Award from the Council of State and Territorial Epidemiologists; the Charles C. Shepard Science Award from the CDC; the Harvey W. Wiley Medal from the Food and Drug Administration; the Squibb Award from the Infectious Diseases Society of America; Distinguished University Teaching Professor, Environmental Health Sciences, School of Public Health, University of Minnesota; and the Wade Hampton Frost Leadership Award, American Public Health Association. He has also received six major research awards from the National Institutes of Health and the CDC.
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April 15, 2020
The U.S. has spent trillions on its military, but the nation’s biggest threat may come in the form of microscopic organisms. “There has never been a time in history when the challenges to controlling and preventing the global spread of infectious disease has ever been this daunting,” says the Director of the Center for Infectious Disease Research and Policy, Dr. Osterholm.
Osterholm and Olshaker review some of the world’s latest infectious disease threats BEFORE COVID-19—diseases that include Zika, Ebola, SARS, and MERS. More importantly, they also lay out a 9-point strategy to address emerging infectious disease threats. The top priority is preventing pandemic flu. [If only the Government had paid attention….]
Of note, Osterholm has a great deal of respect for Dr. Fauci and is less enamored with the WHO. He sees the latter as a slow-moving bureaucracy; but does strongly encourage creation of a multinational organization that would be able to do things like develop new methodologies for manufacturing vaccines. For instance, he believes that a multi-year flu vaccine is possible.
Highly recommend this highly readable discussion of infectious diseases and their prevention.
Osterholm and Olshaker review some of the world’s latest infectious disease threats BEFORE COVID-19—diseases that include Zika, Ebola, SARS, and MERS. More importantly, they also lay out a 9-point strategy to address emerging infectious disease threats. The top priority is preventing pandemic flu. [If only the Government had paid attention….]
Of note, Osterholm has a great deal of respect for Dr. Fauci and is less enamored with the WHO. He sees the latter as a slow-moving bureaucracy; but does strongly encourage creation of a multinational organization that would be able to do things like develop new methodologies for manufacturing vaccines. For instance, he believes that a multi-year flu vaccine is possible.
Highly recommend this highly readable discussion of infectious diseases and their prevention.
May 28, 2020
"...we don't always make rational distinctions between what is likely to kill us and what is likely to hurt us, scare us, or simply make us uncomfortable."
- Michael Osterholm, Deadliest Enemy
I picked this book up after hearing Dr. Osterholm on The Joe Rogan Experience #1439. I could probably write a whole piece about how Joe Rogan has become mainstream. It is a strange world. Anyway, like most of us, I've been a bit consumed in Feb/Mar/Apr 2020 with reading everything I can on infectious disease.
Dr. Osterholm, like Bill Gates, seems almost prophetic in this book. It was published in 2017, but seems prophetic not just in-terms of predicting the crazy aspects of a massive, airborne virus epidemic, but also in recognizing the weaknesses of our global and political preparedness. I guess that is one piece of dealing with epidemiology and public health. You can't just be science-focused, you also have to possess very little naïveté about the way economics and politics impacts public health. Thank God for people like Dr. Osterholm and Dr. Fauci. Their work seems a bit Sisyphean, but still maintain a pretty good perspective as they go on with their research, their realpolitiks, and their gentle persuasion. What a job.
- Michael Osterholm, Deadliest Enemy
I picked this book up after hearing Dr. Osterholm on The Joe Rogan Experience #1439. I could probably write a whole piece about how Joe Rogan has become mainstream. It is a strange world. Anyway, like most of us, I've been a bit consumed in Feb/Mar/Apr 2020 with reading everything I can on infectious disease.
Dr. Osterholm, like Bill Gates, seems almost prophetic in this book. It was published in 2017, but seems prophetic not just in-terms of predicting the crazy aspects of a massive, airborne virus epidemic, but also in recognizing the weaknesses of our global and political preparedness. I guess that is one piece of dealing with epidemiology and public health. You can't just be science-focused, you also have to possess very little naïveté about the way economics and politics impacts public health. Thank God for people like Dr. Osterholm and Dr. Fauci. Their work seems a bit Sisyphean, but still maintain a pretty good perspective as they go on with their research, their realpolitiks, and their gentle persuasion. What a job.
April 6, 2020
This is a critical point in history. Time is running out to prepare for the next pandemic. We must act now with decisiveness and purpose. Someday, after the next pandemic has come and gone, a commission much like the 9/11 Commission will be charged with determining how well government, business, and public health leaders prepared the world for the catastrophe when they had clear warning. What will be the verdict?
If I had read this book in more normal circumstances, I do not know how I would have responded. Perhaps I would have been slightly unnerved, but I think I would have been able to sleep soundly by dismissing most of it as alarmist. In fact, I did just this a few months ago, when I read Bill Bryson’s book on the body, and scoffed at his claim that another 1918-style pandemic was easily possible. Nowadays, however, reading this book is more depressing than anything. Those in the field saw this crisis coming from miles away, but few of us listened. The epidemiological community must feel rather like Cassandras right about now: uttering prophecies that nobody pays any attention to.
(As Osterholm was responsible for most of the ideas in this book, and as it is written from his perspective, I will refer to him as the author in this review.)
This book attempted to be the Silent Spring for infectious diseases. That it did not succeed in doing so is attributable just as much to human nature as to the book itself. Limiting the use of pesticides is fairly easy and relatively painless for most of us. But mobilizing the political will necessary to prepare for health crises in the hypothetical future—preparations that would involve a great deal of money and many institutional changes—is not such an easy sell, especially since we had been lulled into a false sense of security. As is the case with climate change, the dangers seemed so remote and theoretical that for most of us it was difficult to even imagine them.
After witnessing what this new coronavirus has done to our entire way of life in a few short weeks, I was quite disposed to take Osterholm seriously. And I think the entire content of the book—not just the warnings about a potential pandemic—are valuable. Osterholm turns his attention to a wide array of threats: Zika, AIDS, Yellow Fever, Typhoid, Malaria, Ebola, MERS. We are vulnerable on many fronts, and we are generally not doing much to prepare.
One example are the many diseases that are transmitted by mosquito bites. As modern transportation has introduced disease-carrying mosquitos into ever-more parts of the world, and global warming expands the geographic range of mosquitos, this will be an increasing concern. (Silent Spring may, ironically, have contributed to this problem.) Another worry is bio-terrorism. Now that we can see how paralyzing even a moderately lethal virus can be, imagine the damage could be inflicted by a genetically-modified virus. And the technology to edit genes is becoming cheaper by the year. We have already experienced bio-terrorism in the US on a relatively small scale with the 2001 anthrax attacks. This is just a taste of what is possible. According to Osterholm, a mere kilogram of the anthrax bacteria could potentially kill more than an atomic bomb. And it would be far cheaper to acquire.
But these are not even the biggest threats. According to Osterholm, we face two virtual certainties: another flu pandemic, and the imminent ineffectiveness of antibiotics.
The latter is quite terrifying to consider. Antibiotics are not easy to discover, and our arsenal is limited. Meanwhile, bacteria constantly evolve in response to environmental pressures, including to the use of antibiotics. It is inevitable that resistance to available antibiotics will increase; and this could have a profound effect on modern medicine. Even routine operations like knee-replacements would be unsafe if we did not have effective antibiotics. Slight injures—a scratch in the garden from a rose-bush—could result in amputations or even deaths. And yet, antibiotics continue to be widely prescribed for ailments they cannot treat, and given indiscriminately to livestock, which only accelerates the impending bacterial resistance.
The other major threat (as we are learning) is a pandemic. Now, Osterholm was not precisely correct in predicting the cause of the next pandemic, since he thought it would be a flu virus (though he does have a good chapter on coronaviruses, and in any case a flu pandemic is still just as possible). But he is certainly correct in identifying our many structural weaknesses. He notes our lack of stockpiles and correctly predicts a shortage in protective gear, face masks, and ventilators in the event of a pandemic. And though medical science has advanced a lot since 1918, in many ways we are even more vulnerable than we were back then, most notably because of our supply chains. Since so many of our medicines and medical equipment—among other things—are produced overseas, shortages are inevitable if trade is disrupted.
Osterholm is quite illuminating in his discussion of pharmaceutical companies and their incentives. As private businesses, they have little to gain by investing in preventative vaccines or in new antibiotics. In the former case, this is because vaccines have to undergo thorough testing and pass FDA approval, requiring millions in investment, only to face the prospect of uncertain demand once the vaccine hits the market. The case of SARS is instructive. After the disease was identified in 2002, companies rushed to make a vaccine; but when SARS receded, interest in the vaccine disappeared and pharmaceutical companies, cutting their losses, stopped work on the vaccine. We still do not have one.
The incentive system is just as ineffective when it comes to antibiotics. Finding new antibiotics is costly; and since there are currently many cheap antibiotics on the market, a new patented antibiotic probably would not turn a large profit. Besides, effective antibiotic stewardship requires that we use them sparingly, thus further limiting profit potential. Drug companies have much more to gain by creating products that would require continuous use, such as for chronic conditions. Letting the free market decide which drugs get developed, therefore, is not the wisest decision. Osterholm advocates the same approach as taken by government in weapons contracts, wherein the government essentially guarantees payment for any product that meets specifications.
Osterholm’s most ambitious idea for government funding is for a new universal flu vaccine. The flu vaccine we are all familiar with is based on old technology, and can only provide protection from a few strains of flu. Scientists essentially must guess what sort of flu will be circulating in a year; and they must do so every year. But Osterholm thinks that there is good reason to believe that a universal flu vaccine is possible, and recommends we devote at least as much money to such a vaccine as we devote to AIDS research. This seems very sensible to me, since the next pandemic will likely enough come from a flu virus.
I am summarizing Osterholm’s book, but I do not think I am doing justice to its emotional power. Now that I am living through the events that Osterholm predicts (in surprising detail), I feel a strange mixture of outrage and fear: outrage that governments did not listen when they had time, and fear that we will repeat the same mistakes when this current crisis is over. I cannot help but be reminded of another situation in which we comfortably ignore the dire warning of scientists: climate change. My biggest hope for the current crisis, then, is that afterwards we will be more willing to heed the warnings of these nerds in lab coats.
April 1, 2020
HOLY S***. There is a chapter on Corona Virus in this book written several years ago that made me so angry--like we knew this thing was coming--we knew what the likely source was (the ferret meat markets) and we knew it was ugly. We could have stopped this. The other haunting part of this book is at the end where he goes through a bad pandemic scenario and it is literally word for word what we are going through right now (except for he assumes a bare minimum level of Presidential competence, which happens to currently not be the case).
Everyone--especially policymakers--should go back in time immediately and read this book like a few years ago.
Everyone--especially policymakers--should go back in time immediately and read this book like a few years ago.
April 24, 2017
It's an ominous read. Truly.
This is more a 3.5 star because of the "tone". Smug? He says he is accused of being arrogant. Oh his is not a voice of shy estimation, but of exponential estimations. Truthful and instructive. But truly, also fairly stark rapidly approaching horrific tragedy. The future is a pandemic formation- greatly in the odds. Many people, moving quickly from one continent to another continent guarantee it.
If you've read numerous pathogens books, or have thorough knowledge of vectors, bacteria, etc. - then this book will be what you already know. But in a far wider lens of global disease pandemic prevention as it plays out presently.
HIV, Ebola, the bacterial diseases returning, virus formed, and others-many categories are covered well.
But it is still the fast mutating airborne transferred influenza that is the prime player. Coming faster than climate change or any other war weapon scenario to be "the worst". One similar to the 1918 Spanish Influenza that killed more than WWI.
"Humanity has but three great enemies: fever, famine, and war; of these by far the greatest, by far the most terrible, is fever."
This is more a 3.5 star because of the "tone". Smug? He says he is accused of being arrogant. Oh his is not a voice of shy estimation, but of exponential estimations. Truthful and instructive. But truly, also fairly stark rapidly approaching horrific tragedy. The future is a pandemic formation- greatly in the odds. Many people, moving quickly from one continent to another continent guarantee it.
If you've read numerous pathogens books, or have thorough knowledge of vectors, bacteria, etc. - then this book will be what you already know. But in a far wider lens of global disease pandemic prevention as it plays out presently.
HIV, Ebola, the bacterial diseases returning, virus formed, and others-many categories are covered well.
But it is still the fast mutating airborne transferred influenza that is the prime player. Coming faster than climate change or any other war weapon scenario to be "the worst". One similar to the 1918 Spanish Influenza that killed more than WWI.
"Humanity has but three great enemies: fever, famine, and war; of these by far the greatest, by far the most terrible, is fever."
April 22, 2021
Mother Nature is the greatest bioterrorist of them all, with no financial limitations or ethical compunctions.
I cannot recommend this book strongly enough.
Sure, Osterholm comes across as arrogant and kind of a name dropper (he mentions Tony Fauci A LOT), but we can't let that distract from his message and warnings. This book came out three years ago, and it accurately predicts almost exactly what is happening now. He knew, he warned, and we should have heeded.
We cannot overwhelm the pathogens because they so vastly outnumber and outmaneuver us. Our survival depends on outsmarting them.
I find the catastrophe he predicts for 6-9 months out after a situation like ours right now to be particularly disturbing.
Knowledge is power. Read all you can. Prepare how you must.
I cannot recommend this book strongly enough.
Sure, Osterholm comes across as arrogant and kind of a name dropper (he mentions Tony Fauci A LOT), but we can't let that distract from his message and warnings. This book came out three years ago, and it accurately predicts almost exactly what is happening now. He knew, he warned, and we should have heeded.
We cannot overwhelm the pathogens because they so vastly outnumber and outmaneuver us. Our survival depends on outsmarting them.
I find the catastrophe he predicts for 6-9 months out after a situation like ours right now to be particularly disturbing.
Knowledge is power. Read all you can. Prepare how you must.
March 25, 2020
Many leaders of governments are now saying "no one could have predicted this would happen". It's clearly untrue. Experts have been warning us about something like COVID-19 and urging world leaders to take action. This book is accessible to an average non-epidemiologist and clearly demonstrates how incompetent most of the governments are in preventing highly predictable events.
brain-food-tbr
March 13, 2020I'm really liking this Michael T. Osterholm. Found him through this interview
1st Video: https://youtu.be/cZFhjMQrVts
Continuation: https://youtu.be/E3URhJx0NSwa
Chapter 13: SARS and MERS: Harbingers of Things to Come
"An' the dawn comes up like thunder outer China 'crost the Bay!" - Rudyard Kipling
1st Video: https://youtu.be/cZFhjMQrVts
Continuation: https://youtu.be/E3URhJx0NSwa
Chapter 13: SARS and MERS: Harbingers of Things to Come
"An' the dawn comes up like thunder outer China 'crost the Bay!" - Rudyard Kipling
April 12, 2023
На мене ця книжка справила дуже терапевтичне враження. Експерт-пандеміолог з великим досвідом розказує про різні патогени і їх вплив на здоров’я великої групи людей. Всі кейси - з його професійного досвіду. Написано жваво і цікаво, але до короновірусу, тому «особливо» мені сподобалися постапокаліптичні прогнози автора щодо великої пандемії. Він передбачав, що ми згоримо у полум’ї медмакса. Але не згоріли) і тепер нам в Україні часи пандемії здаються благословенними днями спокою та проскрастинаціі. І особливо терапевтично читати цю книгу під звуки вибухів. Думаєш, що всесвітня хвороба, порівняно з війною, не так вже й погано.
З мінусів - публіцистична, політична, меншою мірою наукова.
З мінусів - публіцистична, політична, меншою мірою наукова.
April 8, 2020
Who should read this book, aside from every politician, public health official and anyone having even a remotest role in the medical field? 
September 4, 2021
Ситуація з COVID19 перевернула весь світ з ніг на голову. Безліч обмежнь, карантин, дефіцит продуктів та найнеобхідніших "дрібниць" (маски, респіратори, рукавички, захисні костюми) у лікарнях, відсутність вакцини, загальна паніка та відсутність готовності світу до пандемії - це лиш маленька частина речей, з якими стикнувся світ за останні 1,5 року. Хто б міг подумати, що пандемія "зруйнує злагоджене життя" всього світу?
А от якщо говорити серйозно, то всесвітня пандемія була лиш питанням часу, хоч і говорили про неї в прив'язці до грипу, а не нового виду коронавірусу. От тільки це питання було не на часі у всіх, бо війна чи зміни клімату набагато яскравіші проблеми.
"Смертельний ворог. Людство проти мікробів-убивць" Майкл Остергольм, Марк Олшейкер - це честа і відверта сповідь епідеміолога про ризики та проблеми світу у мікробному плані. Написана дуже просто (ну і звісно переклад не підвів) та доступно, буде чудовим провідником для людей не дотичних до медицини, але які хвилюються про майбутнє та хочуть знати про можливі загрози.
Ця книга дійсно якісний медичний нон-фікшик. У мене не було жодного разу відчуття, що автор заграє з читачем, а не говорить правду. Науково доведені факти, історії боротьби зсередини та цинічний і чіткий посил про майбутню епідемію - автори зробили все, щоб попередити читача про загрозу і що з цим робити.
Малярія, лихоманка Зіка, жовта лихоманка, ВІЛ/СНІД, пандемічний грип, лихоманки Марбург та Ебола, коронавіруси, які викликають MERS та SARS, проблеми антибіотикорезистентності та вакцинації - і ще трошки деталей про епідеміологічний світ сьогодні. + передмова про панлемію COVID19 та застереження на майбутнє. Реалістично, страшно та відверто, але без нот безвиході та відчаю. Саме такі книги нам і потрібні.
Особисто мене найбільше вразив можливий сценарій пандемії, побудований на припущеннях та можливих варіантах подій. І від до жаху схожий з сценарієм подій, які розпочались у 2019 році.
Щира рекомендація для всіх, хто цікавиться даною темою, або ж хоче розширити свої знання.
А от якщо говорити серйозно, то всесвітня пандемія була лиш питанням часу, хоч і говорили про неї в прив'язці до грипу, а не нового виду коронавірусу. От тільки це питання було не на часі у всіх, бо війна чи зміни клімату набагато яскравіші проблеми.
"Смертельний ворог. Людство проти мікробів-убивць" Майкл Остергольм, Марк Олшейкер - це честа і відверта сповідь епідеміолога про ризики та проблеми світу у мікробному плані. Написана дуже просто (ну і звісно переклад не підвів) та доступно, буде чудовим провідником для людей не дотичних до медицини, але які хвилюються про майбутнє та хочуть знати про можливі загрози.
Ця книга дійсно якісний медичний нон-фікшик. У мене не було жодного разу відчуття, що автор заграє з читачем, а не говорить правду. Науково доведені факти, історії боротьби зсередини та цинічний і чіткий посил про майбутню епідемію - автори зробили все, щоб попередити читача про загрозу і що з цим робити.
Малярія, лихоманка Зіка, жовта лихоманка, ВІЛ/СНІД, пандемічний грип, лихоманки Марбург та Ебола, коронавіруси, які викликають MERS та SARS, проблеми антибіотикорезистентності та вакцинації - і ще трошки деталей про епідеміологічний світ сьогодні. + передмова про панлемію COVID19 та застереження на майбутнє. Реалістично, страшно та відверто, але без нот безвиході та відчаю. Саме такі книги нам і потрібні.
Особисто мене найбільше вразив можливий сценарій пандемії, побудований на припущеннях та можливих варіантах подій. І від до жаху схожий з сценарієм подій, які розпочались у 2019 році.
Щира рекомендація для всіх, хто цікавиться даною темою, або ж хоче розширити свої знання.
October 22, 2020
Майже не розкрита тема розробки нових противірусних препаратів, хоча це мене найбільше цікавило.
January 2, 2018
Self-aggrandizing and scientifically unsound.
Even for a book aimed at the general audience, this one is poor on hard facts - not a single photograph or chart or references. I grew rapidly irritated at Osterholm's constant pointing out (and exaggerating) of his contributions as an infectious disease specialist. If you were to believe him, he had predicted every major epidemic of the last 40 years, including HIV-1 and Zika (conveniently enough, he always seems to make these predictions in oral presentations rather than in writing, so that we cannot verify these claims later).
His current battle is against the "gain-of-function" experiments, which he doesn't hesitate to place among the greatest threats against humanity. These were important experiments designed to identify which influenza variants were predictive of the capacity of the virus to be transmitted airborne in an animal model; the experiments were done in highly controlled environments and did not aim at producing a virus that would be more infectious to humans. Truth is, he simply does not fully understand this scientific approach, and/or he is exploiting the cliché of the dangerous "mad scientist" to raise his own profile in the media. Either way, he is doing more harm than good to the pursuit of knowledge.
I was reading this book in preparation for a class I am giving, but rapidly came to the conclusion that it would not provide much valuable materials. What made me stop reading it after 5 or 6 chapters was the ridiculous statement that there were no epidemics in the human population when we were just a small group of animals. There is simply no truth to this, on the contrary. There are plenty of examples of rare animal species and relatively small groups of people that were wiped out by infectious diseases - just think of the diseases brought to Native Americans by European settlers, for instance. Even more wrong is his statement that "you need to have at least a hundred thousand individuals to have a measles epidemic". In fact, the measles virus is one of the most easily transmitted virus we know, which is why it used to infect close to 100% of the human race during childhood before a vaccine was invented. This is one virus (or its ancestor, at least) that you can bet would not have had any difficulty infecting the human race even when we were just a small species (influenza would be another one).
I suppose the general public will learn a few things reading this book, but be warned: some of it will be wrong or misleading. It's the perfect book if you enjoy getting scared about things that are beyond your control, though.
Even for a book aimed at the general audience, this one is poor on hard facts - not a single photograph or chart or references. I grew rapidly irritated at Osterholm's constant pointing out (and exaggerating) of his contributions as an infectious disease specialist. If you were to believe him, he had predicted every major epidemic of the last 40 years, including HIV-1 and Zika (conveniently enough, he always seems to make these predictions in oral presentations rather than in writing, so that we cannot verify these claims later).
His current battle is against the "gain-of-function" experiments, which he doesn't hesitate to place among the greatest threats against humanity. These were important experiments designed to identify which influenza variants were predictive of the capacity of the virus to be transmitted airborne in an animal model; the experiments were done in highly controlled environments and did not aim at producing a virus that would be more infectious to humans. Truth is, he simply does not fully understand this scientific approach, and/or he is exploiting the cliché of the dangerous "mad scientist" to raise his own profile in the media. Either way, he is doing more harm than good to the pursuit of knowledge.
I was reading this book in preparation for a class I am giving, but rapidly came to the conclusion that it would not provide much valuable materials. What made me stop reading it after 5 or 6 chapters was the ridiculous statement that there were no epidemics in the human population when we were just a small group of animals. There is simply no truth to this, on the contrary. There are plenty of examples of rare animal species and relatively small groups of people that were wiped out by infectious diseases - just think of the diseases brought to Native Americans by European settlers, for instance. Even more wrong is his statement that "you need to have at least a hundred thousand individuals to have a measles epidemic". In fact, the measles virus is one of the most easily transmitted virus we know, which is why it used to infect close to 100% of the human race during childhood before a vaccine was invented. This is one virus (or its ancestor, at least) that you can bet would not have had any difficulty infecting the human race even when we were just a small species (influenza would be another one).
I suppose the general public will learn a few things reading this book, but be warned: some of it will be wrong or misleading. It's the perfect book if you enjoy getting scared about things that are beyond your control, though.
April 2, 2023
Гарний спосіб позбутися на певний час тривожності через війну і ядерну зброю. І накрутитись через майбутні пандемії і біотероризм😐
May 18, 2020
“Someday, after the next pandemic has come and gone, a commission...will be charged with determining how well the government, business, and public health leaders prepared the world for the catastrophe when they had clear warning. What will be the verdict?” (Michael Osterholm, 2005)
August 7, 2022
Є глава, де автор у 2017 передбачає, як буде виглядати наступна пандемія, і він правий десь на 70% (але він ставив на грип, а не на коронавірус). Дивне відчуття читати її після пандемії.
Може бути важкувато, якщо нічого не розумієш в біології загалом і у вірусології зокрема.
Може бути важкувато, якщо нічого не розумієш в біології загалом і у вірусології зокрема.
May 25, 2021
Necesario.
March 27, 2020
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.
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.
March 24, 2020
There is no Santa Claus.
This is one of those books that gives me a moment to remember that there are people in this world who know exactly what they're talking about, and they don't mind telling you what's on their mind. I cannot think of a better resource to understand the depth and breadth of what we are up against. The quick and dirty answer is that if you think global warming is frightening and we seriously ought to be doing something about it, you need to think now that the primary reason for this has nothing to do with floods, and everything to do with how temperate zones could become tropical zones and the world ripe for tropical diseases that we know kill millions in the developing world.
The good news is that Bill Gates knows this too and is putting his money where his mouth is. For one thing, I learned that The Bill and Melinda Gates Foundation bankrolls 23% of the WHO's annual budget, and that same World Health Organization operates very much like the UN. Which is to say that when it's wrong, or when it's weak, nobody really corrects it. So here you have the story of the man who absolutely knows on both the science side and the policy side what needs to be done. He lays out the facts, and they are mind bending.
The reason that the world is suffering now and will continue to suffer is that nobody seriously wargames pathogenic pandemics. There can be no solution because there is simply no strategic preparation. Or put more simply, we have no real preppers in any of our governments. If you think preppers are crazy, then you really have no idea about the threat these pathogens present and what you are not facing is the inevitability of the threat. You should start to think of 100 year pandemics like you think about 100 year floods. It's not a matter of if, but a matter of when.
Of course people are fooled by randomness, but it was interesting to learn that the best medical minds in the world are regularly fooled by the randomness of influenza mutations. Most everyone has heard of seasonal flu, and many have heard of H1N1. Consider this excerpt:
We have flu shots we can take, but they don't rid us of flu because we have to guess which of the 198 possibilities is likely to hit. And even when we know it's H1N1, there are still different strains of that. There are nightmare scenarios that are very well known, and by the end of the book you will have heard something that sounds exactly like what is happening today.
There are a host of pathogenic disasters that can happen for all different reasons, some of which are caused by our over prescription of antibiotics. I've read Michael Pollan on this with regard to the threat of feed lots and the tons of antibiotics used in meat and poultry industries, and he is right on target. Pig lungs are very much like human lungs and pigs can play host to pathogens that live in birds. It's just a matter of time before something mutates and makes the jump to humans. These microbes reproduce millions of times per year, mutations are going to happen. But you don't have to do a lot of math to figure it out. Here's the math that makes it easy.
First let's take a current controversy and put it in context. The office associated with the National Security Council that President Trump recently cut has a budget that is under $400 million per year. That's just a little bit more than one F-22 jet fighter. Imagine going to war with one plane. Yes, exactly. We have the equivalent of one fighter plane in a global war on pathogens. The annual budget of the WHO is about 4.4Billion, and they have zero responsibility for developing vaccines or anything like that. They, like the UN, make declarations.
I could give you more dreary details but now you get some fraction of the picture. There are only 6 manufacturers on the planet of for yellow fever vaccine. Combined they can make 50 to 100 million doses per year. There are 3.9 billion people at risk for yellow fever, right now, before global warming. Imagine one dose cost $1.50 (I have no idea). Now you have a baseline way to think of what kind of investment is necessary to beat the diseases we already know about. Nobody is coming close to spending what is needed, or building the infrastructure that will handle epidemics, let alone pandemics.
Millions of people are going to die because millions already die of diarrhea. 2.2 million every year. So infectious disease is already deadly. We know how to fix a lot of it, but we don't. Then of course there are the monsters out there that we know exist and we don't know how to fix. This is a slow motion catastrophe, and it is of the sort we will survive. We pretend that we can afford to have x million people die annually of infectious diseases. They are deadly and they are not Ebola, but Ebola is out there as well. We just remember it because we've seen movies where it's extra scary.
Ebola is the tip of the iceberg. Osterholm shows you the whole thing. You'll never go back to relative ignorance again.
This is one of those books that gives me a moment to remember that there are people in this world who know exactly what they're talking about, and they don't mind telling you what's on their mind. I cannot think of a better resource to understand the depth and breadth of what we are up against. The quick and dirty answer is that if you think global warming is frightening and we seriously ought to be doing something about it, you need to think now that the primary reason for this has nothing to do with floods, and everything to do with how temperate zones could become tropical zones and the world ripe for tropical diseases that we know kill millions in the developing world.
The good news is that Bill Gates knows this too and is putting his money where his mouth is. For one thing, I learned that The Bill and Melinda Gates Foundation bankrolls 23% of the WHO's annual budget, and that same World Health Organization operates very much like the UN. Which is to say that when it's wrong, or when it's weak, nobody really corrects it. So here you have the story of the man who absolutely knows on both the science side and the policy side what needs to be done. He lays out the facts, and they are mind bending.
The reason that the world is suffering now and will continue to suffer is that nobody seriously wargames pathogenic pandemics. There can be no solution because there is simply no strategic preparation. Or put more simply, we have no real preppers in any of our governments. If you think preppers are crazy, then you really have no idea about the threat these pathogens present and what you are not facing is the inevitability of the threat. You should start to think of 100 year pandemics like you think about 100 year floods. It's not a matter of if, but a matter of when.
Of course people are fooled by randomness, but it was interesting to learn that the best medical minds in the world are regularly fooled by the randomness of influenza mutations. Most everyone has heard of seasonal flu, and many have heard of H1N1. Consider this excerpt:
We classify the type A influenza strains—the ones that cause influenza pandemics in both animals and humans—by the characteristics of two proteins on the virion’s surface: hemagglutinin (HA) and neuraminidase (NA). The hemagglutinin has the ability to bind with lung cells it comes in contact with, like a key fitting into a lock, and that is what starts the viral reproduction process. When the cell’s genetic machinery has churned out so many influenza virions that it’s full to bursting, it does burst, and the thousands of new virions move out to bind with other cells. The purpose of the neuraminidase is to allow those virions to escape the cell’s confines and spread to other cells, and even get expelled in the “wind of a cough.” The antiviral drugs that work against most influenza strains—oseltamivir (brand name Tamiflu) and zanamivir (Relenza)—work by obstructing the function of the NA, which is why they are called neuraminidase inhibitors. When we describe type A influenza viruses as H3N2, H1N1, or H5N2, we are referring to their HA and NA components. Technically we refer to influenza viruses by their type and HA and NA characteristics, such as A(H3N2). But for the type A viruses, the ones that cause influenza in humans and animals, we just shorten the name to the HA and NA components, for instance, H3N2. At present, we have identified eighteen distinct type A HA subtypes and eleven NAs, for a total of 198 possible combinations. The most recent pandemic, in 2009, was classified as H1N1—a descendant of the deadly 1918 strain.
Osterholm, Michael T.. Deadliest Enemy (pp. 255-256). Little, Brown and Company. Kindle Edition.
We have flu shots we can take, but they don't rid us of flu because we have to guess which of the 198 possibilities is likely to hit. And even when we know it's H1N1, there are still different strains of that. There are nightmare scenarios that are very well known, and by the end of the book you will have heard something that sounds exactly like what is happening today.
There are a host of pathogenic disasters that can happen for all different reasons, some of which are caused by our over prescription of antibiotics. I've read Michael Pollan on this with regard to the threat of feed lots and the tons of antibiotics used in meat and poultry industries, and he is right on target. Pig lungs are very much like human lungs and pigs can play host to pathogens that live in birds. It's just a matter of time before something mutates and makes the jump to humans. These microbes reproduce millions of times per year, mutations are going to happen. But you don't have to do a lot of math to figure it out. Here's the math that makes it easy.
First let's take a current controversy and put it in context. The office associated with the National Security Council that President Trump recently cut has a budget that is under $400 million per year. That's just a little bit more than one F-22 jet fighter. Imagine going to war with one plane. Yes, exactly. We have the equivalent of one fighter plane in a global war on pathogens. The annual budget of the WHO is about 4.4Billion, and they have zero responsibility for developing vaccines or anything like that. They, like the UN, make declarations.
I could give you more dreary details but now you get some fraction of the picture. There are only 6 manufacturers on the planet of for yellow fever vaccine. Combined they can make 50 to 100 million doses per year. There are 3.9 billion people at risk for yellow fever, right now, before global warming. Imagine one dose cost $1.50 (I have no idea). Now you have a baseline way to think of what kind of investment is necessary to beat the diseases we already know about. Nobody is coming close to spending what is needed, or building the infrastructure that will handle epidemics, let alone pandemics.
Millions of people are going to die because millions already die of diarrhea. 2.2 million every year. So infectious disease is already deadly. We know how to fix a lot of it, but we don't. Then of course there are the monsters out there that we know exist and we don't know how to fix. This is a slow motion catastrophe, and it is of the sort we will survive. We pretend that we can afford to have x million people die annually of infectious diseases. They are deadly and they are not Ebola, but Ebola is out there as well. We just remember it because we've seen movies where it's extra scary.
Ebola is the tip of the iceberg. Osterholm shows you the whole thing. You'll never go back to relative ignorance again.
December 12, 2020
Important to know: This is not an edge-of-your-seat thriller packed with amazing stories of deadly germs and remarkable recoveries.
What it is: A sober presentation about the frightening threats posed by lethal germs. The author is a leading expert in the field of epidemiology in America and the material is informative and authoritative. There are some case stories that make effective points but they're not gripping or memorable. There's an abundance of acronyms and policy discussions. For example:
"Further, an international NSABB-like organization needs to be set up to manage a mutually agreed-upon approach for where and how DURC and GOFRC work should be done globally. This international organization should draw upon the guidance of experts in this area, not simply from the United States, but from around the world. We are under no illusions that such an approach would stop all intentional or unintentional misuse of newly emerging technologies. But to not try to stop it is irresponsible."
If you read it: Be prepared to be troubled. It's hard to read about the multiple deadly looming threats and not feel like we're doomed. The author does offer suggestions to ready our world for the next threat but they're unlikely to happen. Here's an example:
"One of the premises of our Crisis Agenda is that the United States will have to bear both the primary leadership responsibilities and the bulk of the financial burden. The G20 should provide substantial support, but given the relative lack of international support for global public health programs, this is unlikely to happen. Most of the G20 countries have provided only limited financial support for the WHO, have been largely absent in responding to critical regional outbreaks, and have undertaken minimal efforts in new vaccine and antimicrobial drug research and development."
We're screwed.
The best parts of the book: The chapters covering the things we generally hear about more such as vaccines, mosquitoes, antimicrobials and influenza.
Recommended? Yes, as long as you know what the book is not. The highlighted sections may help you make that decision.
What it is: A sober presentation about the frightening threats posed by lethal germs. The author is a leading expert in the field of epidemiology in America and the material is informative and authoritative. There are some case stories that make effective points but they're not gripping or memorable. There's an abundance of acronyms and policy discussions. For example:
"Further, an international NSABB-like organization needs to be set up to manage a mutually agreed-upon approach for where and how DURC and GOFRC work should be done globally. This international organization should draw upon the guidance of experts in this area, not simply from the United States, but from around the world. We are under no illusions that such an approach would stop all intentional or unintentional misuse of newly emerging technologies. But to not try to stop it is irresponsible."
If you read it: Be prepared to be troubled. It's hard to read about the multiple deadly looming threats and not feel like we're doomed. The author does offer suggestions to ready our world for the next threat but they're unlikely to happen. Here's an example:
"One of the premises of our Crisis Agenda is that the United States will have to bear both the primary leadership responsibilities and the bulk of the financial burden. The G20 should provide substantial support, but given the relative lack of international support for global public health programs, this is unlikely to happen. Most of the G20 countries have provided only limited financial support for the WHO, have been largely absent in responding to critical regional outbreaks, and have undertaken minimal efforts in new vaccine and antimicrobial drug research and development."
We're screwed.
The best parts of the book: The chapters covering the things we generally hear about more such as vaccines, mosquitoes, antimicrobials and influenza.
Recommended? Yes, as long as you know what the book is not. The highlighted sections may help you make that decision.
March 31, 2020
This may be one of the most important books you ever read!
Author Michael Osterholm is one of America's leading infectious disease epidemiologists. He has been sounding the pandemic alarm for years, not as a kook, but as a scientist who knows what he's talking about. This book, published in March 2017 contains a scenario which predicts our current COVID-19 crisis almost to a 'T'!
Osterholm details the world's infectious disease fight over his career (beginning before 1980) and includes HIV/AIDS, Ebola, SARS, MERS, and more. He also lays out specific steps he believes the world must take to prevent further pandemics.
I implore everyone to read this book! More importantly, when we get beyond this current COVID-19 crisis, we CANNOT go back to business as usual. America and the world MUST learn a big lesson from the Coronavirus outbreak and begin to address potential public health epidemics in a meaningful and urgent way with very significant resources. In 2019 (one year), the world spent $1,822,000,000,000 (that's 1.8 trillion dollars per Wikipedia) on defense (armies, weapons, research, etc.). A tiny fraction of that amount (1% would be $18 billion) annually could, in a few years, make the world significantly safer from future pandemics, as well as create vaccinations for the 47 known infectious diseases with no current prevention. Sanity needs to set in soon!
Again, please, please read "Deadliest Enemy: Our War Against Killer Germs". (Or one of the handful of other good recent books on this subject.)
Author Michael Osterholm is one of America's leading infectious disease epidemiologists. He has been sounding the pandemic alarm for years, not as a kook, but as a scientist who knows what he's talking about. This book, published in March 2017 contains a scenario which predicts our current COVID-19 crisis almost to a 'T'!
Osterholm details the world's infectious disease fight over his career (beginning before 1980) and includes HIV/AIDS, Ebola, SARS, MERS, and more. He also lays out specific steps he believes the world must take to prevent further pandemics.
I implore everyone to read this book! More importantly, when we get beyond this current COVID-19 crisis, we CANNOT go back to business as usual. America and the world MUST learn a big lesson from the Coronavirus outbreak and begin to address potential public health epidemics in a meaningful and urgent way with very significant resources. In 2019 (one year), the world spent $1,822,000,000,000 (that's 1.8 trillion dollars per Wikipedia) on defense (armies, weapons, research, etc.). A tiny fraction of that amount (1% would be $18 billion) annually could, in a few years, make the world significantly safer from future pandemics, as well as create vaccinations for the 47 known infectious diseases with no current prevention. Sanity needs to set in soon!
Again, please, please read "Deadliest Enemy: Our War Against Killer Germs". (Or one of the handful of other good recent books on this subject.)
May 1, 2020
Deadliest Enemy is an extremely important book to read during our fight against COVID-19. Michael Osterholm is an esteemed epidemiologist- infectious disease specialist-of our time. He is a founding director of Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota. He has been on the forefront of public health preparedness and has led many outbreak investigations of international importance. He advises world leaders of the growing list of microbial threats. He has been on the news a lot lately.
Deadliest Enemy is a powerful and necessary book that looks at the threat of emerging diseases with clarity. It is based on solid scientific evidence. He offers plans on many of which are being followed today during COVID-19 pandemic. He questioned why we have spent billions on the “war on terror” but virtually nothing for an inevitable calamity that can kill millions.
Osterholm answers important questions like why people need flu shots, why antibiotics are becoming increasingly ineffective and which pathogens are the biggest threat to humanity. It is a question of when. The authors explain how catastrophes like earthquakes, tsunamis and hurricanes are localized but the 1918 style influenza outbreak effects are global like COVID-19 today. It is almost chilling to read his modern-day influenza pandemic scenario that he and his colleagues mapped out about 2.5 years ago for government and other officials to pay attention o and how much of it replicates COVID-19 occurring today.
This is an extremely pertinent book and shows how unprepared we are for pandemics. It is a great read especially for what we are going through right now. He knows what he is talking about. I recommend this book.
Deadliest Enemy is a powerful and necessary book that looks at the threat of emerging diseases with clarity. It is based on solid scientific evidence. He offers plans on many of which are being followed today during COVID-19 pandemic. He questioned why we have spent billions on the “war on terror” but virtually nothing for an inevitable calamity that can kill millions.
Osterholm answers important questions like why people need flu shots, why antibiotics are becoming increasingly ineffective and which pathogens are the biggest threat to humanity. It is a question of when. The authors explain how catastrophes like earthquakes, tsunamis and hurricanes are localized but the 1918 style influenza outbreak effects are global like COVID-19 today. It is almost chilling to read his modern-day influenza pandemic scenario that he and his colleagues mapped out about 2.5 years ago for government and other officials to pay attention o and how much of it replicates COVID-19 occurring today.
This is an extremely pertinent book and shows how unprepared we are for pandemics. It is a great read especially for what we are going through right now. He knows what he is talking about. I recommend this book.
November 30, 2020
Thanksgiving is over and the warnings about the new COVID continue, along with hopeful teases about vaccines. Time to get back to reading about epidemics and pandemics.
“Deadliest Enemy” is a republication of a work by Michael Osterholm and his coauthor Mark Olshaker reviewing his career of studying and combating epidemics and pandemics. Osterholm is a professor at Minnesota who is arguably one of the most experienced public health experts in the world. He was recently appointed to Biden’s new COVID Task Force. He has been a regular consulting expert on TV during the COVID-19 pandemic and is one of the most knowledgeable and understandable experts around, He is especially persuasive at combining the scientific and policy dynamics of diseases and is one of the clearer TV experts around.
This book is a tour of most of the major disease groups and provides evidence of the varieties of different ailments along with a sense of how public health experts can pursue and attempt to subdue such a varied group around the world. Some of the disease situations are really scary, readers be warned. The major topics go by chapter and start with general aspects of how the public health profession works and thinks about diseases and epidemics. This includes how diseases get transmitted and how vaccines work and what is involved in developing them. Other chapters cover the major disease areas of interest to public health experts, including malaria, AIDS, TB, Ebola, SARS, MERS, and various mosquito borne ailments, including the Zika virus. There are good chapters on disease resistant bacteria and what is at risk in fighting disease resistance. The book finishes with chapters on influenzas and other potential pandemics. These are topics one hears about in listening to coverage of COVID-19 but Osterholm explains and contextualizes them well. It is impressive. Of particular interest is a later chapter that presents a scenario of how a flu pandemic might play out worldwide. This scenario was written before Trump was elected and long before anyone heard of the COVID-19 virus. It will sound scarily familiar on many dimensions.
This is one of the better nonfiction books in the pandemic literature, even if it does not address COVID-19. It is reassuring to read about this from a credible and knowledgeable expert who know how to communicate.
“Deadliest Enemy” is a republication of a work by Michael Osterholm and his coauthor Mark Olshaker reviewing his career of studying and combating epidemics and pandemics. Osterholm is a professor at Minnesota who is arguably one of the most experienced public health experts in the world. He was recently appointed to Biden’s new COVID Task Force. He has been a regular consulting expert on TV during the COVID-19 pandemic and is one of the most knowledgeable and understandable experts around, He is especially persuasive at combining the scientific and policy dynamics of diseases and is one of the clearer TV experts around.
This book is a tour of most of the major disease groups and provides evidence of the varieties of different ailments along with a sense of how public health experts can pursue and attempt to subdue such a varied group around the world. Some of the disease situations are really scary, readers be warned. The major topics go by chapter and start with general aspects of how the public health profession works and thinks about diseases and epidemics. This includes how diseases get transmitted and how vaccines work and what is involved in developing them. Other chapters cover the major disease areas of interest to public health experts, including malaria, AIDS, TB, Ebola, SARS, MERS, and various mosquito borne ailments, including the Zika virus. There are good chapters on disease resistant bacteria and what is at risk in fighting disease resistance. The book finishes with chapters on influenzas and other potential pandemics. These are topics one hears about in listening to coverage of COVID-19 but Osterholm explains and contextualizes them well. It is impressive. Of particular interest is a later chapter that presents a scenario of how a flu pandemic might play out worldwide. This scenario was written before Trump was elected and long before anyone heard of the COVID-19 virus. It will sound scarily familiar on many dimensions.
This is one of the better nonfiction books in the pandemic literature, even if it does not address COVID-19. It is reassuring to read about this from a credible and knowledgeable expert who know how to communicate.
July 14, 2019
Osterholm warns that the end of the world will consist of plague unless we do something about preparedness. He outlines the major threats as he sees them (pandemic flu, antibiotic resistance, mosquito-borne disease, etc.), as well as a few courses of actions, and winds things up with a terrifying tabletop exercise that describes the consequences of a flu pandemic with our current level of preparedness. (The world doesn't end, but lots of people die.)
I'm...not sure who he wrote this for? Congress critters? The science-literate general public? It's not a great time to be alive if your personal bugbear is preparing for public health disasters, between the anti-vaxxers, the massive overuse of antibiotics, and the general sense of "well, that's their problem" with regards to black and brown people dying of diseases "we" don't have "here". The government's not showing a strong face either, losing credibility between disasters like Hurricane Katrina, the Flint water crisis, and "concentration camp internees don't need soap"; plus the CDC's basically sneaking around funding things while hoping Trump doesn't take notice of them.
A good overview of stuff you can reasonably expect to kill lots of people in the next fifty years. Osterholm's engaging and because of his experience and how his education and career lined up with the last few decades of the 20th century, he's got quite a few, "no shit, there I was" anecdotes tht are worth reading.
(Full disclosure - I took Osterholm's Emerging Infectious Disease course in grad school and he seems to have vomited it up in book form here. The course was interesting and he's an engaging asshole with three decades of amazing experience and anecdotes. He was also the only professor I had who required students to apply for the privilege of being in his class, and I still haven't quite forgiven him for 1) assigning excruciatingly boring group projects and 2) constantly soliciting the opinions of the only man in the class. He's the sort of man you give a pass to as a professional woman only because every other man at his level is magnitudes of order worse and you have to work with someone to get anything done.)
I'm...not sure who he wrote this for? Congress critters? The science-literate general public? It's not a great time to be alive if your personal bugbear is preparing for public health disasters, between the anti-vaxxers, the massive overuse of antibiotics, and the general sense of "well, that's their problem" with regards to black and brown people dying of diseases "we" don't have "here". The government's not showing a strong face either, losing credibility between disasters like Hurricane Katrina, the Flint water crisis, and "concentration camp internees don't need soap"; plus the CDC's basically sneaking around funding things while hoping Trump doesn't take notice of them.
A good overview of stuff you can reasonably expect to kill lots of people in the next fifty years. Osterholm's engaging and because of his experience and how his education and career lined up with the last few decades of the 20th century, he's got quite a few, "no shit, there I was" anecdotes tht are worth reading.
(Full disclosure - I took Osterholm's Emerging Infectious Disease course in grad school and he seems to have vomited it up in book form here. The course was interesting and he's an engaging asshole with three decades of amazing experience and anecdotes. He was also the only professor I had who required students to apply for the privilege of being in his class, and I still haven't quite forgiven him for 1) assigning excruciatingly boring group projects and 2) constantly soliciting the opinions of the only man in the class. He's the sort of man you give a pass to as a professional woman only because every other man at his level is magnitudes of order worse and you have to work with someone to get anything done.)
April 16, 2020
Honest. Chilling. Published in 2017, this book by former Minnesota State Epidemiologist and expert in public health foresaw quite a bit of what we're living through now (especially our unpreparedness). Warning: this book is not light reading. The chapters on tuberculosis, smallpox, malaria, dengue fever, yellow fever, ebola, zika virus, earlier instances of corona viruses, (SARS, MERS), anti-microbial resistance, and influenza make for some grim - but also eye-opening and enlightening - reading.
Along the way, you get a better understanding of what epidemiologists do, a better understanding of the economics of vaccines, and the reasons that the process of approval for new medicines is so demanding, rigorous and strict. (How comfortable would you be to learn that the Administration that is fast-tracking use of a malaria drug for treatment of COVID-19 is headed by a man who owns part of the company that manufactures the drug in the U.S.?)
In the course of the current pandemic, I learned that one set of my great-grandparents, living in rural Galicia (Western Ukraine) died in the Great Pandemic of 1918-19. That brought things home for me, and helped me to better understand the life of my maternal grandmother. These bugs are real. They really kill. A community may appear to be healthy one day, and be decimated by the end of the next. Many more people died in several months in the 1918-19 pandemic than died in the four years of WW1 (estimates range from 50 million people to roughly twice that number).
Osterholm is sometimes accused of being alarmist, but I've never thought of him that way. He ends the book with a quote from The Christmas Carol by Charles Dickens:
"Men's courses will foreshadow certain ends, to which, if persevered in, they must lead," said Scrooge. "But if the courses be departed from, the ends will change. Say it is thus with what you show me."
Along the way, you get a better understanding of what epidemiologists do, a better understanding of the economics of vaccines, and the reasons that the process of approval for new medicines is so demanding, rigorous and strict. (How comfortable would you be to learn that the Administration that is fast-tracking use of a malaria drug for treatment of COVID-19 is headed by a man who owns part of the company that manufactures the drug in the U.S.?)
In the course of the current pandemic, I learned that one set of my great-grandparents, living in rural Galicia (Western Ukraine) died in the Great Pandemic of 1918-19. That brought things home for me, and helped me to better understand the life of my maternal grandmother. These bugs are real. They really kill. A community may appear to be healthy one day, and be decimated by the end of the next. Many more people died in several months in the 1918-19 pandemic than died in the four years of WW1 (estimates range from 50 million people to roughly twice that number).
Osterholm is sometimes accused of being alarmist, but I've never thought of him that way. He ends the book with a quote from The Christmas Carol by Charles Dickens:
"Men's courses will foreshadow certain ends, to which, if persevered in, they must lead," said Scrooge. "But if the courses be departed from, the ends will change. Say it is thus with what you show me."
October 23, 2020
Досі вразливі
Невидимі, весь час мутують та адаптуються. Мікроорганізми завше поруч з нами з початку віків і не раз косили людство, викликаюяи різні хвороби. Ця книга коротко і наочно висвітлює одну з найбільших проблем людства - непідготовленість до епідемій та банальне не вжиття необхідних заходів наперед. Глобалізація принесла чимало плодів, насамперед комфорт, але також вона дозволяє мікроорганізмам подорожувати туди, куди раніше вони рідко діставалися. Глобалфзація також вдарила по найпотужнішим країнам тим, що їм вкрай непросто буде відновити виробнийтва вакцин та інших засобів потрібних в час епідемії. Направду Захід не вямться на помилках минулого, відтак приречений завше потерпати від хвороб.
Невидимі, весь час мутують та адаптуються. Мікроорганізми завше поруч з нами з початку віків і не раз косили людство, викликаюяи різні хвороби. Ця книга коротко і наочно висвітлює одну з найбільших проблем людства - непідготовленість до епідемій та банальне не вжиття необхідних заходів наперед. Глобалізація принесла чимало плодів, насамперед комфорт, але також вона дозволяє мікроорганізмам подорожувати туди, куди раніше вони рідко діставалися. Глобалфзація також вдарила по найпотужнішим країнам тим, що їм вкрай непросто буде відновити виробнийтва вакцин та інших засобів потрібних в час епідемії. Направду Захід не вямться на помилках минулого, відтак приречений завше потерпати від хвороб.
August 29, 2017
This book is a sobering account of our general lack of preparedness for a variety of pandemic illnesses. As described by the author, the potential for social devastation from unchecked disease or related problems, such as the rise of antibiotic resistant bacteria, is much greater than most people realize. Furthermore, this book makes it clear that some kind of catastrophic situation is likely to occur eventually (it's not about "if" but rather about "when"). After reading this book I was left wondering why our political institutions aren't doing more to counter this threat. We seem to be suffering from a case of misplaced priorities.
December 25, 2021
It's fun to read these books that predicted the pandemic and see what they got right and what they got wrong. Did I say fun? I mean horrifying and dispiriting. Also scary to contemplate the other predictions and the huge prescription for preventing and fighting the next global health challenges.
I read this because I've specifically developed an interest in Osterholm's insight and perspective on Covid on the news and in his podcast so I looked to see what he'd previously written.
I read this because I've specifically developed an interest in Osterholm's insight and perspective on Covid on the news and in his podcast so I looked to see what he'd previously written.
December 29, 2020
Круть, читається, як детектив
March 8, 2022
This book is a must read for anyone wanting to understand the deadliest viruses and bacteria that humanity is facing. It was written in 2017, 2 years before the covid pandemic and it is prophetic in its predictions. The diseases covered by the book include: AIDS, TB, malaria, yellow fever, dengue, zika, ebola, SARS, MERS and influenza.
A summary of the main points:
- the greatest means of transmission of diseases are bats (greatest reservoirs of viruses), bugs (usually mosquitos), lungs (airborne transmission) and penises (sexual transmission).
- Malaria, yellow fever, dengue and zika are all carried by mosquitos. Since the 1970s there has a complete neglection of the fight against mosquitos which has led to the re-appearance of many diseases which were thought to be eradicated. Due to globalisation mosquitos are now carried by transport ships all over the world and this will lead to the appearance of these diseases in new places
- gain of function and dual use research which has the potential of creating so called Chimaera viruses which combine the characteristics of several deadly viruses into one
- Vaccines are the best way of fighting pandemics however the costs are enormous and pharmaceutical companies will not be able to able to develop vaccines for rare diseases if they are not assisted by governments.
- Ebola a disease that comes out of Africa and at the moment has not been able to spread too much but there is still a possibility of mutation. The worst mutation would be if it would mutate to become airborne
- SARS and MERS are two of the coronaviruses that are discussed. This chapter is probably the most shocking because the stage was already set for future coronavirus pandemics after the previous outbreaks, yet the world did nothing to prepare itself
- Antimocrobial resistance is probably one of the biggest threats to mankind. It is estimated by 2050 the current antibiotics we have will no longer be effective against many microbes. This is because large scale use of antibiotics in humans but more so in animals has led to the development of antibiotic resistant microbes. This will lead to the horror scenario of medicine returning to the XIXth century, people dying from simple infections and hospitals not being able to treat people due to the fear of infection. The ways to fight this scenario is by large scale reduction of antibiotic use all over the world, developing new antibiotics and developing new ways to fight microbes.
- Influenza is considered the greatest threat with the potential to impact the whole world. Diseases like AIDS or TB can impact large groups of people but only influneza has the ability to impact the whole world at the same time. The book briefly covers influenza pandemics of 1918 (Spanish flu), 1957 (Asian flu) and 1968 (Hong Kong flu) but also describes a nightmare scenario of a future influenza pandemic which could have as many as 300 million dead.
The main takeaways of the book is that in the future it is likely that we will face pandemics that will be a lot more deadly and we could be defenseless against them. The author talks about the likelihood of future pandemic like a game of chance, it is not about if it will happen but rather when it will happen. The reasons for the increase in the number of pandemics are:
- humans are cutting down forests and coming in contact more and more with animals that are carrying diseases
- humans in poor countries live close together in slums which allows for the disease to spread
- humans are travelling more like ever before and can carry the disease from one place to another
- there are several places in the world where humans, pigs and poultry live close together which means that the virus can easily jump from one species to another
Not only does the book talk about these threats it even proposes a 9 point action plan on how to tackle them. The most important thing being that the world must come together and fight against these deadly threats. The author talks about the inability of the WHO to deal with pandemics and as such proposes the creation of a NATO-like organisation equipped with dealing with biological threats. Just as countries invest billions in weapons for defense (especially nuclear) they should be investing the same amounts in research and pandemic preparation.
A summary of the main points:
- the greatest means of transmission of diseases are bats (greatest reservoirs of viruses), bugs (usually mosquitos), lungs (airborne transmission) and penises (sexual transmission).
- Malaria, yellow fever, dengue and zika are all carried by mosquitos. Since the 1970s there has a complete neglection of the fight against mosquitos which has led to the re-appearance of many diseases which were thought to be eradicated. Due to globalisation mosquitos are now carried by transport ships all over the world and this will lead to the appearance of these diseases in new places
- gain of function and dual use research which has the potential of creating so called Chimaera viruses which combine the characteristics of several deadly viruses into one
- Vaccines are the best way of fighting pandemics however the costs are enormous and pharmaceutical companies will not be able to able to develop vaccines for rare diseases if they are not assisted by governments.
- Ebola a disease that comes out of Africa and at the moment has not been able to spread too much but there is still a possibility of mutation. The worst mutation would be if it would mutate to become airborne
- SARS and MERS are two of the coronaviruses that are discussed. This chapter is probably the most shocking because the stage was already set for future coronavirus pandemics after the previous outbreaks, yet the world did nothing to prepare itself
- Antimocrobial resistance is probably one of the biggest threats to mankind. It is estimated by 2050 the current antibiotics we have will no longer be effective against many microbes. This is because large scale use of antibiotics in humans but more so in animals has led to the development of antibiotic resistant microbes. This will lead to the horror scenario of medicine returning to the XIXth century, people dying from simple infections and hospitals not being able to treat people due to the fear of infection. The ways to fight this scenario is by large scale reduction of antibiotic use all over the world, developing new antibiotics and developing new ways to fight microbes.
- Influenza is considered the greatest threat with the potential to impact the whole world. Diseases like AIDS or TB can impact large groups of people but only influneza has the ability to impact the whole world at the same time. The book briefly covers influenza pandemics of 1918 (Spanish flu), 1957 (Asian flu) and 1968 (Hong Kong flu) but also describes a nightmare scenario of a future influenza pandemic which could have as many as 300 million dead.
The main takeaways of the book is that in the future it is likely that we will face pandemics that will be a lot more deadly and we could be defenseless against them. The author talks about the likelihood of future pandemic like a game of chance, it is not about if it will happen but rather when it will happen. The reasons for the increase in the number of pandemics are:
- humans are cutting down forests and coming in contact more and more with animals that are carrying diseases
- humans in poor countries live close together in slums which allows for the disease to spread
- humans are travelling more like ever before and can carry the disease from one place to another
- there are several places in the world where humans, pigs and poultry live close together which means that the virus can easily jump from one species to another
Not only does the book talk about these threats it even proposes a 9 point action plan on how to tackle them. The most important thing being that the world must come together and fight against these deadly threats. The author talks about the inability of the WHO to deal with pandemics and as such proposes the creation of a NATO-like organisation equipped with dealing with biological threats. Just as countries invest billions in weapons for defense (especially nuclear) they should be investing the same amounts in research and pandemic preparation.
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