What do you think?
Rate this book
Outbreak Culture: The Ebola Crisis and the Next Epidemic, With a New Preface and Epilogue
As we saw with the Ebola outbreak—and the disastrous early handling of the COVID-19 coronavirus pandemic—a lack of preparedness, delays, and system-wide problems with the distribution of critical medical supplies can have deadly consequences. Yet after every outbreak, the systems put in place to coordinate emergency responses are generally dismantled.
One of America’s top biomedical researchers, Dr. Pardis Sabeti, and her Pulitzer Prize–winning collaborator, Lara Salahi, argue that these problems are built into the ecosystem of our emergency responses. With an understanding of the path of disease and insight into political psychology, they show how secrecy, competition, and poor coordination plague nearly every major public health crisis and reveal how much more could be done to safeguard the well-being of caregivers, patients, and vulnerable communities. A work of fearless integrity and unassailable authority, Outbreak Culture seeks to ensure that we make some urgently needed changes before the next pandemic.
One of America’s top biomedical researchers, Dr. Pardis Sabeti, and her Pulitzer Prize–winning collaborator, Lara Salahi, argue that these problems are built into the ecosystem of our emergency responses. With an understanding of the path of disease and insight into political psychology, they show how secrecy, competition, and poor coordination plague nearly every major public health crisis and reveal how much more could be done to safeguard the well-being of caregivers, patients, and vulnerable communities. A work of fearless integrity and unassailable authority, Outbreak Culture seeks to ensure that we make some urgently needed changes before the next pandemic.
304 pages, Paperback
Published September 28, 2021
42 people are currently reading
1877 people want to read
About the author
Pardis Sabeti
2 books8 followersPardis Sabeti is Professor of Organismic and Evolutionary Biology at Harvard University and Professor of Immunology and Infectious Diseases at the Harvard T. H. Chan School of Public Health. A member of the Broad Institute and a Howard Hughes Medical Institute Investigator, Sabeti was named a World Economic Forum Young Global Leader, a National Geographic Society Emerging Explorer, and one of Time magazine’s 100 Most Influential People of 2015. She is also the recipient of an NIH New Innovator Award and a Richard Lounsbery Award from the National Academy of Sciences.
Ratings & Reviews
Friends & Following
Create a free account to discover what your friends think of this book!
Community Reviews
Displaying 1 - 13 of 13 reviews
April 11, 2019
As a public health preparedness person, this is the most simultaneously depressing and yet life affirming book I have read in a long time. I spend so much time making all the points in this book, all of which seem so obvious and are thrown out the window so quickly in an event.
People not in the field will be shocked and disappointed.
My colleagues are asking me about this book and am telling them- Worst thriller ever, you know exactly who did it. All of it.
People not in the field will be shocked and disappointed.
My colleagues are asking me about this book and am telling them- Worst thriller ever, you know exactly who did it. All of it.
January 1, 2021
As I was reading the book, I felt an inescapable sense of anger, despair, and mistrust in international agencies, governments, and individuals whose corruption has continually costed us millions of lives. Padis sabeti, as a global health worker herself, was bold in publishing this book that unravels the behind the scenes of outbreaks when “You have never seen people drop their ethical standards so fast”.
This book discusses the Ebola epidemic, what went wrong, and what we could do (could have done) better in the next (current) epidemic. So, naturally, reading it now, almost a year into the covid-19 pandemic made it much more interesting by allowing me to compare the two major public health crises, through pointing similarities and drawing conclusions.
“We forget the lessons we learn from outbreaks, so we make the same mistakes.” —Nahid Bhadelia
The ebola crisis could’ve prepared us for the next epidemic, but it didn’t . I would have to argue that it was not because we forgot the lessons, but simply because politics remained the same for the past four years, therefore, our response was destined not to change and to stay inefficient, even though we had the knowledge required to tackle it from day one!! The book also uncover the political chaos in Sierra Leone that caused the Ebola Crisis to be as devastating as it was, and how it was affected by the country’s political background. This is definitely one of the weakest points about global health; its inherent connection to politics!
The Sierra Leone, Liberia, and Guinea models provide good case studies for the devastating results of health crises in an already politically corrupt country, therefore, making me doubt my own country’s ability of moving beyond the current pandemic
“Certainly, dysfunctional health systems and lack of trust in authorities in a war-ravaged region contributed to the devastation. But among the most destructive factors were international indifference and what we call outbreak culture.”
Perhaps what remains to be the most devastating truth is that, even though both crises had affected African countries, much more attention was paid towards covid-19, undoubtedly because it had affected developed countries as well. Which inherently disregards the universality of public health.
The current pandemic is not the great equalizer everyone assumes it to be. We are facing the same storm, but we’re not on the same boat! Health, financial, and social disparities are destined to root even deeper because of it. The sooner we realize that we are as strong as the weakest part of the chain is, the sooner we’re able to move past this pandemic.
As the book shows you the dark sides of healthcare and humanity as a whole, It also proposes ethical dilemmas in public health, and provides good case studies on how international agencies could (and often did) fail vulnerable populations.
“We are working to advocate for you all, but we are not sure we have a say ourselves,” Sabeti wrote in an email to Khan, recognizing that they had little sway over the larger agencies.” And when the MSF led center refused to give Dr. Khan the experimental drug that could’ve saved his life, in order to protect their reputation!!! You can say MSF’s arguments were valid, however, not allowing access to an experimental drug was downright unethical. So is monopolizing data, scientific colonialism, exploiting diseases and feeding into fear for personal gains. All of which this book has perfectly highlighted.
Studying medicine for six years and learning about how common diseases are has instilled in me a belief that sickness is the norm, rather than health (1 in 2 women will have cancer in their lifetime, 1% of the population have ulcerative colitis, more women have PCOS than those who don’t, and other fun stats).
Now, after reading this book, I am slapped with humanity’s darkest truths of impending failures, the inherently less valuable lives of third world citizens, and the monopolization of health, even in the midst of disease.
Although this was a difficult read, it was fun nonetheless. It felt like reading case series reports in a medical journal, a memoir, and WHO guidelines at the same time. You can tell it was written by college professors since its immaculacy, attention to details, and heavily cited reports are similar to those done in academia. And as a final note to close off; I remain hopeful that the current pandemic would enable increased funding for public health research and global health policy development.
This book discusses the Ebola epidemic, what went wrong, and what we could do (could have done) better in the next (current) epidemic. So, naturally, reading it now, almost a year into the covid-19 pandemic made it much more interesting by allowing me to compare the two major public health crises, through pointing similarities and drawing conclusions.
“We forget the lessons we learn from outbreaks, so we make the same mistakes.” —Nahid Bhadelia
The ebola crisis could’ve prepared us for the next epidemic, but it didn’t . I would have to argue that it was not because we forgot the lessons, but simply because politics remained the same for the past four years, therefore, our response was destined not to change and to stay inefficient, even though we had the knowledge required to tackle it from day one!! The book also uncover the political chaos in Sierra Leone that caused the Ebola Crisis to be as devastating as it was, and how it was affected by the country’s political background. This is definitely one of the weakest points about global health; its inherent connection to politics!
The Sierra Leone, Liberia, and Guinea models provide good case studies for the devastating results of health crises in an already politically corrupt country, therefore, making me doubt my own country’s ability of moving beyond the current pandemic
“Certainly, dysfunctional health systems and lack of trust in authorities in a war-ravaged region contributed to the devastation. But among the most destructive factors were international indifference and what we call outbreak culture.”
Perhaps what remains to be the most devastating truth is that, even though both crises had affected African countries, much more attention was paid towards covid-19, undoubtedly because it had affected developed countries as well. Which inherently disregards the universality of public health.
The current pandemic is not the great equalizer everyone assumes it to be. We are facing the same storm, but we’re not on the same boat! Health, financial, and social disparities are destined to root even deeper because of it. The sooner we realize that we are as strong as the weakest part of the chain is, the sooner we’re able to move past this pandemic.
As the book shows you the dark sides of healthcare and humanity as a whole, It also proposes ethical dilemmas in public health, and provides good case studies on how international agencies could (and often did) fail vulnerable populations.
“We are working to advocate for you all, but we are not sure we have a say ourselves,” Sabeti wrote in an email to Khan, recognizing that they had little sway over the larger agencies.” And when the MSF led center refused to give Dr. Khan the experimental drug that could’ve saved his life, in order to protect their reputation!!! You can say MSF’s arguments were valid, however, not allowing access to an experimental drug was downright unethical. So is monopolizing data, scientific colonialism, exploiting diseases and feeding into fear for personal gains. All of which this book has perfectly highlighted.
Studying medicine for six years and learning about how common diseases are has instilled in me a belief that sickness is the norm, rather than health (1 in 2 women will have cancer in their lifetime, 1% of the population have ulcerative colitis, more women have PCOS than those who don’t, and other fun stats).
Now, after reading this book, I am slapped with humanity’s darkest truths of impending failures, the inherently less valuable lives of third world citizens, and the monopolization of health, even in the midst of disease.
Although this was a difficult read, it was fun nonetheless. It felt like reading case series reports in a medical journal, a memoir, and WHO guidelines at the same time. You can tell it was written by college professors since its immaculacy, attention to details, and heavily cited reports are similar to those done in academia. And as a final note to close off; I remain hopeful that the current pandemic would enable increased funding for public health research and global health policy development.
wishlist-nonfiction
August 18, 2020
January 28, 2019
The author’s raise serious questions around epidemics that need to be addressed by not only medical professionals but also governments before a health crisis occurs. I had never considered the nuances of an outbreak culture before reading this insightful work. At certain points, this book made me very afraid at how unprepared we are socially and culturally to deal with potentially devastating global events such as a horrific epidemic. Although the authors presented an agenda for preparations before an epidemic, it is doubtful that, in the current world-wide political nationalistic stance, that any of their ideas of cooperation will be addressed in the near future.
April 14, 2024
Haiku summary:
Many lessons learned.
For global health protection.
Open and honest.
Many lessons learned.
For global health protection.
Open and honest.
May 17, 2020
Outbreak Culture explores the 2014 Ebola outbreak in West Africa where it reveals the factors that contributed to the rapid spread of the virus and exacerbated the dire circumstance ranging from sociopolitical cultures to the indifference and greediness of international governments and organizations.
History indeed has a nature of repeating itself, the factors that caused the epidemic in West Africa is comparable to what has caused the current situation at this juncture that spiraled from worst to devastation. It provides answers as to why was the virus not contained in at the beginning and how effective is the non-pharmaceutical intervention such as quarantine in the event of an outbreak crisis.
It is worth stressing that the level of compliance of the public remains the sole determinant of the effectiveness of quarantine measures. Pardis Sabeti and Lara Salahi argue that compliance can only be achieved if they perceive the measure to be caring followed by a comfortable experience. On the contrary, the adverse effect will take place and individual resistance will materialize should it be imposed in a punitive manner furthering the mistrust of the citizen to the authorities.
The mistrust of the West African citizens to their government is a product of a long history of exploitation and colonialism. This mistrust breeds conspiracy theories in times of fear and is as contagious and deadly as the pathogen itself. Some hospitals were ransacked and health workers sent to villages were faced with threats and intimidations because the locals were led to believe that the virus was hoax and government-made.
Similar distrust appeared during this current pandemic crisis where circulating rumor on social media urging those who have shown symptoms to disclose their condition and avoid hospitals as they would be deliberately murdered there to prevent further contagion. This is an utter absurdity, but by looking at it through the context of the history of oppression aggravated by the emotion of current fear and panic, we will not be surprised to learn the source of that skeptic and distrustful mindset.
There are recurring traits, that are as lethal as the virus itself, that often manifest during the height of an outbreak. People of a certain race, as in the case of most viral outbreaks in history, were usually used as a scapegoat or a victim of stigma and discrimination. They could be the West Africans during Ebola, the Chinese during SARS, and in the local case, the Maranaos during COVID-19 at Mindanao. Politicians, on the other hand, tend to ride to the perception of the public by imposing measures based merely on worries and not on any scientific or medical information which is obviously counterintuitive.
“If we lose sight that this was an outbreak of infectious disease and we blame the epidemic on something existential, we’ll be doing a great disservice.”
Enter the region, build up its health systems, conduct research during and between epidemics, care for the afflicted, and send swiftly in personnel and supplies is the most effective response to an outbreak according to the authors. Another is the collaboration between international and local interagency. It is imperative to have an existing mechanism of sharing of information at the international level in its early stage by acknowledging the outbreak immediately despite the negative international attention to contain the virus promptly. It requires recognition, reporting, verification, and response.
This authoritative book provides its readers with an overview of the factors the led to the outbreaks from spreading exponentially and harming individuals. It could have been prevented had it not been for the sociopolitical culture underlying the outbreak response that hampered the much effective methods in curbing and defeating the deadly pathogen. In light of the current pandemic crisis, this deficiency needs to be addressed by the government and to eschew the usual all or nothing approach.
Furthermore, the outbreak culture that we have has to be rectified if we want to prevent another devastating pandemic from taking place again. As the authors stated, "Dangerous pathogens are usually ignored until they reach an epidemic or pandemic scale. This must change. So, too, must the culture that is formed during an outbreak response.”
History indeed has a nature of repeating itself, the factors that caused the epidemic in West Africa is comparable to what has caused the current situation at this juncture that spiraled from worst to devastation. It provides answers as to why was the virus not contained in at the beginning and how effective is the non-pharmaceutical intervention such as quarantine in the event of an outbreak crisis.
It is worth stressing that the level of compliance of the public remains the sole determinant of the effectiveness of quarantine measures. Pardis Sabeti and Lara Salahi argue that compliance can only be achieved if they perceive the measure to be caring followed by a comfortable experience. On the contrary, the adverse effect will take place and individual resistance will materialize should it be imposed in a punitive manner furthering the mistrust of the citizen to the authorities.
The mistrust of the West African citizens to their government is a product of a long history of exploitation and colonialism. This mistrust breeds conspiracy theories in times of fear and is as contagious and deadly as the pathogen itself. Some hospitals were ransacked and health workers sent to villages were faced with threats and intimidations because the locals were led to believe that the virus was hoax and government-made.
Similar distrust appeared during this current pandemic crisis where circulating rumor on social media urging those who have shown symptoms to disclose their condition and avoid hospitals as they would be deliberately murdered there to prevent further contagion. This is an utter absurdity, but by looking at it through the context of the history of oppression aggravated by the emotion of current fear and panic, we will not be surprised to learn the source of that skeptic and distrustful mindset.
There are recurring traits, that are as lethal as the virus itself, that often manifest during the height of an outbreak. People of a certain race, as in the case of most viral outbreaks in history, were usually used as a scapegoat or a victim of stigma and discrimination. They could be the West Africans during Ebola, the Chinese during SARS, and in the local case, the Maranaos during COVID-19 at Mindanao. Politicians, on the other hand, tend to ride to the perception of the public by imposing measures based merely on worries and not on any scientific or medical information which is obviously counterintuitive.
“If we lose sight that this was an outbreak of infectious disease and we blame the epidemic on something existential, we’ll be doing a great disservice.”
Enter the region, build up its health systems, conduct research during and between epidemics, care for the afflicted, and send swiftly in personnel and supplies is the most effective response to an outbreak according to the authors. Another is the collaboration between international and local interagency. It is imperative to have an existing mechanism of sharing of information at the international level in its early stage by acknowledging the outbreak immediately despite the negative international attention to contain the virus promptly. It requires recognition, reporting, verification, and response.
This authoritative book provides its readers with an overview of the factors the led to the outbreaks from spreading exponentially and harming individuals. It could have been prevented had it not been for the sociopolitical culture underlying the outbreak response that hampered the much effective methods in curbing and defeating the deadly pathogen. In light of the current pandemic crisis, this deficiency needs to be addressed by the government and to eschew the usual all or nothing approach.
Furthermore, the outbreak culture that we have has to be rectified if we want to prevent another devastating pandemic from taking place again. As the authors stated, "Dangerous pathogens are usually ignored until they reach an epidemic or pandemic scale. This must change. So, too, must the culture that is formed during an outbreak response.”
January 29, 2020
One of those books that reminds us how territorial we are even when collaborating is in our best interest. Thankfully there are people who are working on behalf of all people, and not just their own bank accounts or personal power. It also highlights the dangerous nature of viruses and the larger danger of delaying responses to outbreaks.
April 17, 2020
I read this book last year and I am currently reading it again. It make so much more sense when you are living everything this book describes. #pandemic
April 15, 2022
This book details the response to the 2014 Ebola outbreak, covering what happened, what went wrong, and why. This book will be a delight to those who enjoy a deep dive into policy and the failures of governments and institutions to work together to fight a pandemic and what we can do better in the future. The authors are well versed in the details and discuss not only the country's response, but also the global health organizations and also how the outbreak was handled in the United States. In light of the current Covid-19 pandemic, it is interesting to compare and contrast the responses, to see where humanity has learned lessons and where it did not. My favorite quote from the book is prescient: “There is a good chance that the world will see at least one pandemic during the coming century, and a 20% chance of four or more. Standard measures of outbreak control will not be adequate to handle these future health crises. The more contagious the pathogen, the more difficult it will be to contain. And, as we saw with Ebola, the more time the virus has to spread from human to human, the more infectious it can become. To prepare for this threat, we need to shift outbreak response to a m
January 7, 2023
This book was written before the COVID-19 pandemic. It is amazing how this book almost predicts what happened. Everything this book talks about rang true in 2020. It's cliche, but history is doomed to repeat itself. This book is not just informative it's also a warning. We need to be prepared for future outbreaks before they hit. We need to focus on the culture of an outbreak and less on stupid bickering.
I loved this book. It was an eye opener. I wish that every politician making any kind of public health decisions was required to read this book first.
If you want to learn more about other parts of an outbreak besides the pathogens themselves, read this book.
I loved this book. It was an eye opener. I wish that every politician making any kind of public health decisions was required to read this book first.
If you want to learn more about other parts of an outbreak besides the pathogens themselves, read this book.
December 26, 2020
Interesting read. I’m reminded of the importance to behave compassionately toward each other and that beyond the pandemic, we have the opportunity for new technologies and capacities to combat pathogens. Let’s not let history repeat itself.
May 30, 2021
No doubt a important book but its repetitive and I feel like the points could have been steamed down into less pages and words. Not the most enjoyable read but I want to let you to know that English is my second language.
August 6, 2020
Interesting how outbreaks work and I learned a ton.
Displaying 1 - 13 of 13 reviews