Spike: The Virus vs. The People - the Inside Story

by Jeremy Farrar, Anjana Ahuja

The Coronavirus pandemic has devastated lives and livelihoods around the world - and continues to do so. These personal tragedies will, and must, be told and heard. There is, however, also a truthful and objective scientific narrative to be written about how the virus played out and how the world set about dealing with it. Spike is that story - from the inside. Its author, Jeremy Farrar, is one of the UK's leading scientists and a ��member of the SAGE emergency committee.
As head of the Wellcome Trust, and an expert in emerging infectious diseases, Jeremy Farrar was one of the first people in the world to hear about a mysterious new respiratory disease in China - and to learn that it could readily spread between people. Farrar describes how it feels as one of the key scientists at the sharp end of a fast-moving situation, when complex decisions must be made quickly amid great uncertainty. His book casts light on the UK government's claims to be 'following the science' in its response to the virus, and is informed not just by Farrar's views but by interviews with other top scientists and political figures.
Farrar, who has spent his career on the frontlines of epidemics including Nipah virus in Malaysia, bird flu in Vietnam and Ebola in West Africa, also reflects on the wider issues of Covid-19: the breath-taking scientific advances in creating tests, treatments and vaccines; the challenge to world leaders to respond for the global good and the need to address inequalities that hold back success against the virus. All these shape how the world ultimately fares not just against Covid-19, but against all the major he��alth challenges we face globally.

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

272 pages, Paperback

First published July 22, 2021

About the author

Sir Jeremy Farrar is director of the Wellcome Trust and chair of the WHO's R&D Blueprint, which activates rapid research in an epidemic. He is an expert on emerging infectious diseases and a member of the UK's pandemic advisory group, SAGE. He was one of the first people in the world to know about and alert the global community to Covid-19.

Reviews

[Masrur · Rating 4 out of 5]

This book provides an immensely valuable insight into the pandemic and the UK's handling of it. Prof Sir Jeremy Farrar was there at the heart of it and was clearly plugged in with the right people. It confirms what most people already knew — the UK's response was dire throughout the pandemic.

It also appears that Prof Farrar had come exclusive conversations for the purposes of this book. Key players like Prof John Edmunds (LSHTM), Prof Neil Ferguson (Imperial), Maria Van Kerkhove (WHO) and Dominic Cummings (No. 10) are directly quoted throughout in quotes that I do not think are public. This provides a fascinating insight into what key people were thinking.

One specific point that was a bit confusing was Prof Farrar's rejection of herd immunity and SAGE's involvement with it. It is difficult to convincingly argue that "SAGE had nothing to do with herd immunity" when the Chair of SAGE has said it publicly, and the concept is indirectly littered throughout early SAGE papers (e.g early SAGE papers say they are unanimous that suppression leads to a worse second wave — if you follow that point through, you arrive at naturally acquired herd immunity, surely). A key argument against herd immunity is apparently provided by a SAGE member, Steven Riley, however, that note is not published alongside the rest of the SAGE minutes and papers.

Another minor discrepancy is what Prof Farrar identifies as the key SAGE meeting. Prof Farrar says it is the 13 March meeting. However, Patrick Vallance is on record saying it was the 16th. Here, Prof Farrar somewhat exploits the ambiguity of the SAGE minutes from 13 March to reinforce his point. Either way, it is even more damning for the Government if it had been warned as early as 13 March and it took 10 days to impose lockdown.

I started to question Prof Farrar's motives behind this book. One of the features that became apparent throughout the book was that scientists had started to become politicians (they arguably had to given the dearth of political leadership). I asked myself whether this was an attempt to re-write history to paint a more favourable picture of some people (as Cummings has already done so with his testimony).

The book also extensively (and perhaps selectively?) refers to Prof Farrar's confidential email updates to his colleagues at Wellcome. To me, this is a literary device to say "look, I was saying it all along". The problem is that those emails were not shared widely and were not public. In essence, they achieved nothing. Could Prof Farrar have made more of an impact if he was saying all these things on the record?

Queries/criticisms aside, this was a fascinating book. Ultimately, the forthcoming public inquiry will be the judge of all.

[Sam · Rating 4 out of 5]

Very readable, thorough and crammed with actual facts and references/knowledge to back it up, reaffirming just how incompetent the government are and how lucky they are to have such a strong scientific community to bail them out. In a just society there would be a series of arrests made once the inquiry finally happens, Jan-Feb '21 was entirely avoidable. However, I fully expect Johnson to be knighted and the whole clown car of money grubbing cunts in power to continue to fail upwards. Still, at least we still have people like this dude and his mates trying to be heard, for now at least.

[Peter · Rating 5 out of 5]

Incredibly well written and informative book. A shame that the people who failed us either through negligence, misguided self-importance, self-interest or pure incompetence will either fail to read this or ignore the lessons learned even if they do. I can only wish it had been a book of fiction rather than modern history though.

[John Calver · Rating 4 out of 5]

Overall an interesting record of COVID ,quite rightly points the finger at faults in the UK response and lessons to be learned globally. Made me think about our battle with climate change and somewhat depressingly came to the conclusion that billions will die over the next few hundred years by which stage a Jeremy Farrar character will say “ we should have done x,y z”
One downside of the book is that Jeremy comes across as full of his own importance , and rather biased to the scientific community. Note the comparison between Dominic Cummings rule breaking and similar from Neil Ferguson .

[Peter Myers · Rating 4 out of 5]

Oh my goodness!
This book, written mainly from the perspective of the UK (but with lessons for us in Australia) clearly lays out an epidemiologists view of the virus timeline, and the many, many, bungling mistakes that led to the current situation.

I learnt a new TLA…”NPI” non pharmaceutical intervention.
When a new unknown highly transmissible virus is identified, the only response is using NPI to control the spread. In the UK (and the USA) the government’s and specifically their leaders, Johnson and the clown Trump, simply did not believe what they were being told by the epidemic specialists, refused to implement full NPI, and the result is…history.

Johnson, Trump and many other world leaders bungled along with half measures, preferring their own political agendas over a strategy to contain the virus.

By the end of 2020, it would no longer be possible to eradicate the virus…ever, but science had created a solution for management and containment. It was no longer a scientific challenge, but a political one!!!

And…we are not except from criticism here in Australia. Had we ordered vaccines (different vaccines) sooner, in large quantities, we would not be in the position we are all fed up with currently of having to still rely on NPI (lockdown etc)

During 2019 it was estimated by the WHO that the USA and the UK were the top two countries in the world capable of responding to and managing a pandemic outbreak, primarily because of their mature health systems, their scientific research capabilities, and their response capability! By the end of 2020 the USA and the UK were amongst the worst hit by COVID, and ultimately it is suspected, gave birth to the more infectious Delta variant!

Yes, cover up, conspiracy theories and shenanigans are all at play here.
Read it and weep…

[SparklyHedgehog]

Jeremy Farrar, scientist and doctor, former Director of the Wellcome Trust, and now Chief Scientist at the World Health Organisation, was a beacon of sense, calm and scientific integrity during the COVID pandemic. During the pandemic I often turned to his Twitter feed to find out what was going on, and what should be going on, in the UK and worldwide with respect to governments' response to the pandemic. There was often a large gap between what Farrar said the UK government should be doing, and what the UK government was actually doing, despite the Prime Minister Boris Johnson's mantra that he was "following the science".

This is a well written, clear and thoughtful book by Farrar and his co-author Anjana Ahuja, a science columnist and freelance writer. Farrar was a member of the SAGE committee that advised the UK government on COVID, and gives his insider's view of what was happening in SAGE and in Johnson's government at that time. It's shocking to hear how little attention Johnson and many of his closest associates paid to the scientists' advice, and the consequences of that lack of attention and seriousness. Despite having world-leading scientists to advise it, the UK had the highest death toll from COVID in the whole of Europe. One particularly striking example of the effect of ignoring the scientists was the UK government's delaying the decision to declare a lockdown:
"In June 2020, [epidemiologist] Neil Ferguson told the House of Commons Science and Technology Select Committee that locking down one week earlier would have halved the death toll. By the time Neil spoke, around 40,000 people in the UK had lost their lives to coronavirus. That was, on the face of it, an appalling miscalculation: 20,000 lives swapped for an extra week of liberty."

Farrar pulls no punches with respect to his view of Johnson, for example, he reports a conversation in which Johnson's advisor Dominic Cummings said to Johnson that "Look, much of the media is insane, you've got all of these people running around saying there can't be a second wave, lockdowns don't work, and all this bullshit. [...] They were being picked up by pundits and people like Chris Evans [the 'Telegraph' editor] and Bonkers Hitchens [Peter Hitchens]" and Johnson replied "The trouble is Dom, I'm with Bonkers. My heart is with Bonkers, I don't believe in any of this, it's all bullshit. I wish I'd been the Mayor in 'Jaws' and kept the beaches open".

This book illustrates huge importance of efffective communication between scientists and politicians/policy-makers, a topic not just relevant to COVID but also to other important health and scientific issues affecting the world such as climate change, biodiversity, etc.
To me it's terrible to hear that the most powerful person in the UK government, who was being advised by some of the country's top scientists, didn't believe what they were saying and instead relied on scientifically unsound notions such as "taking it on the chin" to inform public health policies that affected millions of people's lives and resulted in 1000s of unnecessary deaths. Farrar makes it clear that the UK, with its excellent scientific advisors and dedicated health workers, need not have lost so many lives during the pandemic, and the fact that it did was due to extremely poor political decision-making and poor coordination between government departments.

Interestingly, Farrar quotes Timothy Gowers, British mathematician and Fields medallist, as saying in March 2020 that it was obvious that the best strategy was to go in hard and early on interventions like lockdowns, because of exponential growth in case numbers. "All it needed, Timothy says, was an understanding of basic mathematics." I found this point very interesting; was the reason that Johnson and other government ministers paid too little attention for too long to SAGE's advice on early lockdowns simply because they didn't understand the basic Maths behind an exponential curve? If so, this would be a strong argument in favour of a stronger emphasis on Maths education in UK schools. I would be interested to know whether scientists fared better in communicating epidemiological concepts to government ministers in countries where there is a stronger emphasis on Maths throughout both primary and secondary education?

Farrar, one of the best-connected and influential scientists in global health in the UK and indeed worldwide, was one of the first people to hear about COVID in late 2019, and his account of those first days and weeks of the pandemic is riveting. His contact list is like a who's-who of the top people working in global health, for example, one of the first things he did was to send a text message to George Gao, head of the Chinese Centre for Disease Control and Prevention. I'd say not many people have George Gao's number! Because Farrar was one of the first to hear about COVID, he also felt a huge weight of responsibility to do the right thing by alerting the right people in a timely manner. His account of those early days when only a handful of people outside China knew about COVID is extremely gripping, as he reveals the huge anxiety and pressure he shouldered and his worries that the virus may have been manufactured by humans (which has now been ruled out) or that he could be in danger by having information that powerful governments may have wished to suppress. There are many quotes from emails and text messages from that worrying time that bring immediacy and a personal touch to his remembrances.

In the later part of the book Farrar and Ahuja focus on the question of how the world can prepare for the next pandemic, which may be from an unexpected virus, bacterium or parasite, and the important question of how to promote equity in preparedness and in response (e.g. vaccine equity, for COVID but also for any new pandemic-causing species). One ethical issue that he doesn't discuss, which I wish he had, is whether, to achieve global health equity, more of the money and effort poured into COVID research, and now being spent on pandemic preparedness, should have been spent (and should spent in future) on other diseases that arguably have bigger impact in the very poorest countries e.g. malaria, HIV, T.B, cholera?

[Leah · Rating 4 out of 5]

There were things I didn't like about this book, but I have no hesitation whatsover in recommending it. The account of the science and pandemic are clear and compelling, I learned a huge amount. What I found tiresome was the name-dropping and autobiographical elements: 'I then texted X person and put them in touch with Y etc.' The book did, however, redeem itself in the final chapter with some persuasive, targeted, institutional changes which can improve global public health systems. I particularly enjoyed reading about the incredible Sharon Peacock, who seems to me to be an unsung hero of the pandemic in the UK. I think it's interesting that two of the most important interventions, from her and Kate Bingham, came from women when so much of the process was dominated by men.

[Maisie Jenkins · Rating 4 out of 5]

Well written, honest and important book - liked it more than I thought I would!!

[Sam Still Reading · Rating 4 out of 5]

I’ve been enjoying reading about the different aspects of the COVID-19 pandemic and Spike has been quite hard to get hold of in Australia, despite it being published in 2021. However, it’s definitely a book worth tracking down if you’re interested in how expertise and leadership can be no match for power and politics.

Spike details the first 18 months of the COVID-19 pandemic in the UK, from the first mutterings about a new virus to lockdowns, overcapacity healthcare and tens of thousands of deaths. It’s told from Jeremy Farrar’s perspective as an expert on infectious disease and practical knowledge on epidemics. He was also a member of the UK SAGE committee on COVID-19, advising the government. It starts as the virus is contained to Wuhan, then slowly spreads before exponential growth across the world. It’s a unique insight as Farrar’s informal talks with colleagues and other experts combine with the advice offered to the UK government on how to manage the pandemic. The warnings about hospitals being overloaded and hundreds of thousands of excess deaths are still chilling to read, as are the thoughts about a virus made by humans (which turned out to be false, but there are some very gripping, spy-like moments).

As the book goes on, I found that this was not simply another pandemic book. It’s a book about power, who holds it and what they do with that power. We talk about leadership and leaders in their respective fields, but what happens when other leaders don’t listen to the expert leaders? What happens when recommendations are changed, ignored or delayed? It seemed at times that science and data were being neglected for the economy, for freedom and perhaps politics. Sometimes it seemed like nobody was willing to take the lead and carry the responsibility of implementing closure of schools, pubs and shops. Of course this is only one side of the story, but there are various email excerpts and others who verify what happened. This was frankly scary to me (and a little too familiar at times from across the world…’gold standard’ anyone from Australia?)

One thing I really liked about this book is that it had a who’s who list at the back, as when you don’t know all the people involved it can be quite confusing to follow. The first chapters were very engrossing even though I knew what the unknowns were, it almost read like a thriller novel. It’s easy to understand and chilling reading at times thinking about the responsibilities experts and public figures have and how that gets conveyed to the general public.

http://samstillreading.wordpress.com

[Philip William · Rating 5 out of 5]

The book is written by Jeremy Farrar who was a member of Sage whilst the COVID pandemic swept through the UK
This is an important book to understand the incompetence at the heart of Government and particularly within Sage when dealing with the COVID pandemic.
To me the heart of the book is found in the comments by Steven Riley who emailed Jeremy on 10 March 2020 that (based on his research in Hong Kong in 2003) people would change their behaviour in response to COVID and therefore that an epidemic could not rip through the UK population quickly because people would shut themselves away as infection rates rocketed and intensive care units filled up. Both of their responses to this observation appear to be that we should therefore lockdown rather than trust the people and build up health care capacity. Jeremy does not explain why he believes that the Sage approach is better but there appears to be an unwritten assumption that freedom is bad even if it has better health outcomes.
Jeremy consistently argues for more Government spending while at the same time pointing out that Governments are incompetent and cannot be trusted.
In Chapter 1 he points out that the best global monitoring of diseases are by unpaid volunteers through the ProMED-mail and indeed Jeremy first heard about the disease on 30 December 2019. In the same chapter he reveals how he was involved in forcing the hands of WHO and China to reveal details of the new disease.
In Chapters 4 and 5 Jeremy describes how while the rest of London was changing its behaviour Sage was so incompetent that it was meeting in underground rooms with poor circulation so that half of Sage end up with COVID.
On a number of occasions Jeremy points out that Sage is an advisory group and then complains when the Government does not take his advice. At the same time he seems to have no idea of the costs that he is imposing by his proposed actions including the very narrow question of how many deaths he caused by advocating lockdowns at every opportunity.

[Eleanor · Rating 5 out of 5]

An immaculately crafted political thriller taking you to the heart of the decision-making behind the explosion of the Covid pandemic. As the director of the Wellcome Trust, Jeremy Farrar advised the government with the help of epidemiologists and SAGE members about how to defend the UK from the advancing tide of Covid. Faced with the science, the government did nothing, delayed, and caused tens of thousands of unnecessary deaths. It's enraging, and you can't tear the book from your hands. Unsurprisingly, perhaps, Dominic Cummings was the major proponent for change within the government, pushing for lockdown and social distancing measures when Boris Johnson and Matt Hancock erred. Johnson literally turned a blind eye - we all know he missed several COBRA meetings in January and February, but he even missed one the week before the overdue March 2020 lockdown. There are some catty asides that you can't help but devour (Cummings slammed the door in Hancock's face at important meetings, and gossips that Boris was too busy with the transitioning roles of girlfriends and his Shakespeare book to fully realise the threat of Covid) but they are in fact, jaw-dropping indictments of political stupidity.

Spike has the propulsion of a spy novel. There's a blood-chilling moment near the beginning of the book where scientists suspect the COVID pathogen may have been scientifically engineered due to the startling efficiency of the spike protein. They break government-mandated silences, get hounded by the press, and even fear for their lives ... just for governments to sniff out the trail of bad science with the false hope that herd immunity can save us. Instead, it damns us.

This is a tale of political negligence, and the inevitable slaughter that followed. Not just in the staggering ignorance of 2020, but in a decade of pain and austerity that left an emaciated national health service to face a ruthless killer. We had no chance.

[Henry Gee · Rating 4 out of 5]

Passionate, polemical and partisan, this is a first-hand account of the first year or so of the Coronavirus pandemic from one at the eye of the storm. Farrar is the Director of the Wellcome Trust, an expert on the spread of epidemics, and was a member of SAGE, the group of scientists advising the UK government on policy — if only the government cared to listen. Ahuja is a journalist who pulled Farrar’s diary of the plague year into the form of something like a thriller. The large cast of characters and the forest of organisational acronyms can be hard to navigate but there’s a helpful glossary and dramatic personae at the end. This is very much a view from the trenches and does not count as a comprehensive history of the pandemic, for much is omitted. There is almost nothing on, say, the efficacy of wearing masks; the studies showing that the virus does not live on surfaces; and the pernicious effects of the anti-vaccination movement. And although the author does like to take political pot shots, his view is selective. He discusses the former (Labour) Prime Minister Gordon Brown (with whom he is on first-name terms) although his role was peripheral, yet nowhere at all does he mention the (Conservative) then-Chancellor Rishi Sunak and his colleagues at the Treasury whose heroic work kept the economy alive during the lockdown. Although it is regrettably true that the Conservative Party is historically very poor at understanding science, balance should not be a casualty of the author’s understandable frustration. Nevertheless, when the history of the pandemic comes to be written, this will be important source material. Shortlisted for the Royal Society Science Book Prize 2022 (DISCLAIMER: I also have a dog in that fight).

[David Jennings · Rating 3 out of 5]

Recommended to me by a friend, as an insight into how politics deals with scientific advice. In a nutshell: filtered through its own myopia, while looking in a different direction, and with a chorus of extraneous noise to attenuate any signal that might get through. In the political sphere, Dominic Cummings - for all his personal failures to act in good faith - comes across as the one who has some interest and grasp of the issues. The ex-journalists, Johnson and Gove ("remarkable largely for his absence"), can't be bothered with details at the best of times, and certainly not in a sphere that doesn't cleave to their ideological mission. I got to the end of the end of the book fully expecting that the UK will repeat the same mistakes a third (or is it fifth?) time. The book is good on all the health players, national and international, and how they reconfigure themselves, with varying degrees of vision and competence, to react to the new challenges. The stars of the story are able to improvise and align others to their goals while keeping their eye on sound scientific method and balance of probabilities. Farrar evidently didn't keep any kind of journal, because he relies a lot on quoting from his email outbox, so none of the accounts of meetings have the drama you get with some other memoirs. I _think_ he's a reliable narrator, though I'd love to see some short reviews by some of the others mentioned in this account.

[Eric Anderson · Rating 4 out of 5]

The recent pandemic was such a world changing event which altered all our lives, but I think so many of us were left reeling as it happened so fast and we all had to scramble to understand what was going on. So it's invaluable to read the inside perspective of someone who is an expert on infectious diseases and who was one of the first people to hear about this mysterious new respiratory disease in China. Jeremy Farrar traces the history of this pandemic from the first outbreak, explains the nature of the disease and why a failure to properly contain and report on it helped it to spread across the globe. The title refers not only to spikes in infections as the disease was traced through different countries, but also the spike protein found on the surface of Covid-19 virus cells which aids it in invading the body. Not only does he give an inside perspective on the medical channels across the globe which sought to understand it and rapidly develop a vaccine, but as a member of the SAGE emergency committee he gives an invaluable perspective on the UK's uneven plan for dealing with this outbreak.

Read my full review of Spike by Jeremy Farrar at LonesomeReader

[Rebecca · Rating 4 out of 5]

An important &, despite it’s Summer 2021 release, still a timely read. Also interesting to readers around the world, the premise is a focus on the UK pandemic response but there is a global focus too, the first few chapters are particularly strong in dealing with the rapid, concurrent changes at the very start of the pandemic.
The book also deals well with the Origin conspiracy & Herd Immunity strategy & the insider’s perspective has changed my opinion on some key players. It is a very male story, although that reflects the state of play in these key roles, rather than the authors’ bias. I did feel the Oxford AZ vaccine was explored in a continuously unfavourable light, with early (& glowing) focus on Moderna.
The latter chapters on Delta seemed a bit sparse, given what healthcare workers actually went through over that period. Also as Farrar has himself said we are currently only about halfway through the pandemic, the conclusion seemed a little preemptive, but raised important points for the next pandemic.

[Carole · Rating 5 out of 5]

Very revealing history of this pandemic, from first indications that this was serious up to very recent evens written by scientist who has first hand knowledge, it reads almost like a spy story but it’s fact! It doesn’t super coat or excuse the lack of openness of politicians from China to our own government,
What is positive is the scientists who strive for exploring the facts, discovering how, why , these viruses evolve spread and mutate,and how to control spread, how it needs an international approach at all stages, and how scientists are prepared to work together if politics is left out!
Political needs, it seems can overtake scientific evidence, Sage is the British advisory body but Johnson chose not to attend five initial meetings when it was vital that preventative measures should have been taken, if politicians refuse to act on advice the difficulties for scientists getting action is inevitable, but then they are blamed!
I found it a fascinating read,

[Maxwell · Rating 4 out of 5]

4.1/5
Very engaging and informative. It definitely provides me with a fresh and more reflective perspective on the whole COVID situation, particularly from a UK based pov. I enjoy the first half of the book greatly. The second half, though still somewhat engaging, feels a bit more bland and policy focused. I wish Jeremy could explain more science behind the vaccine research and testing pipeline, and expand even more on March 2021 onward. However given he gotta publish this book in time and it’s also geared towards the public not academia, it’s understandable. I also wish to hear his take on the current China’s strategy against COVID given the rest of the world has basically accepted it to stay.
Overall, a great read! Felt like a sci fi l yet it’s the reality we are living in and through.

My 2022 reading has been somewhat funky. I used to only read one book at a time, but now I am reading four in parallel. (Maybe blame it on Dune)
So we will see!

[Coffee & books · Rating 3 out of 5]

Not great because it's too biased. Also, too many quotes from emails and messages, it got boring to read those.
I would have liked a bit more analysis of why they thought lockdowns would not work instead of blaming the government of not wanting to impose lockdowns (which was mirrored in EU, Germany went into lockdown 2 days before UK). If the scientists thought lockdowns will not work, why would anybody else. Also, the masks are brushed over and not engaged with enough, because it was a failure of the scientists?

A lot can be learned, but all involved need to have the humility of accepting their own faults. The government did a poor job and lockdowns could have been imposed earlier, travel ban could have been imposed from February. I think that's more important than what Cummings said or if Johnson attended a meeting or not.

[Debby Binns · Rating 4 out of 5]

This is a brilliant book and so well written (it reads like an adventure story). It begins with Farrar sitting in an airport on Christmas Eve in 2019, waiting to come home to see his family when he receives a phone call – as it transpires, a covert phone call from a colleague in China, who is aware of what’s happening and wants to tell him. That’s how it begins. He goes on to explain how, in the beginning, there was so much resistance - not just from China, but from the US and other countries, because leaders did not want to believe this epidemic was real. At various points, which he explains so well - he genuinely feared for his life, because only a very few people in the world knew that something truly dreadful was happening.
I highly recommend this book to anyone who is interested in learning about the UK and Covid from a renowned scientist.

[Graham · Rating 3 out of 5]

This is an insider's recollection of the Covid pandemic, told as a diary narrative. It is pacey and revealing. It shows how dependent the UK was upon a few people who had sufficient knowledge of how diseases spread to understand the significance of facts emerging from China in Dec 2019. It also shows how difficult it was for those people to get the civil service and politicians to understand that significance.
Farrar is not shy is apportioning blame and he 'gets his retaliation in first'. It will be interesting to see whether this book needs revision when more evidence becomes available (and in light of the public enquiry by which time this book will long since have faded in our memories).

[Geoff Garnett · Rating 5 out of 5]

A well written contemporary account of the response to Covid-19 focusing on the UK. Leading the preeminent funder of health research in the UK Jeremy is at the center of a network of excellent health researchers and brings the insights from that network to light. Jeremy is right to point out that we were lucky in the profile of mortality this time, and that we need to establish better mechanisms to respond to pandemics. It is depressing to consider how far away we are from this with health care funding and provision geared to treating rather than preventing disease. It is hard to see how the incentives can be sufficiently changed to enable a better system.

[To3m · Rating 4 out of 5]

The first half was deeply interesting. It focused on January 2020, as the pandemic was beginning, the scientists sounding the alarm on the international scene whilst wrestling with personal dilemmas.
What really resonated was how important it is to have competent people controlling the levers of power whilst in a crisis. Spike showed time and again how this was not the reality for the UK during the corona virus crisis.
The second half of the book became a little repetitive, mirroring reality as the second lockdown approached and it was clear that the lessons of the first had not yet landed for many.

[Jeff Noble · Rating 2 out of 5]

An enlightening stroll through a frontliner with a vastly different worldview and opinion than I do. Published in mid-2021, some of his assertions have not aged well. I encourage the book to be read and digested as a helpful perspective to understand the reasoning behind support of lockdowns, mass vaccination, etc. Because I have read widely for the past two years on the subject, I was sad to read of Farrar and WHO, WEF and SAGE leaders refusing to consider available drug remedies and therapeutic treatments or consider dissenting science and data. He was definitely tunnel-visioned, advocating world vaccination as the only viable exit strategy.

[Ryan · Rating 3 out of 5]

This book was reasonable as "inside story of bad UK response to the first 18 months of Covid", but not great in light of what's happened since, and really pretty narrowly focused on the UK. There are better books which cover more of the Covid saga in time and geography (Uncontrolled Spread is probably the best), better books about future epidemics, and thus not much reason to read this one unless you really care about UK politics and people who are no longer in government. It did bring up the Sweden/Nordic model a bit, but didn't dive too deeply; if there were a geographical area which would be worth studying for global relevance, China wins first, followed by Sweden.

[Jack D · Rating 5 out of 5]

One of the rare books that seems to sit in the non-fiction thriller category. The first half is an incredible insiders account of the coronavirus outbreak and response across the world and more specifically in the UK. Including a damning assessment of lots of the big decision makers in government, most of which were the elected officials. The second half is more reflective and forward looking, discussing potential trajectories for COVID-19 and how we might deal with some of the big questions on vaccine equity, ongoing surveillance, and preparation for the next pandemic (or variant). Highly recommended even though the conclusions are somewhat depressing.

[Rosie · Rating 4 out of 5]

Spike is a fascinating look back at the pandemic from the perspective of one of the scientists involved from the start. Almost like a diary of the pandemic, we see Farrar first getting wind of the new virus through to the various emails and meetings about it to the vaccine movement. It was both incredibly interesting seeing the pandemic from this angle, but also incredibly frustrating seeing how governments, the British government in particular, handled things in contrast to the advice being given. Definitely worth a read for anyone interested in learning a bit more about the rise of Covid and why things ended up how they did.

[Nicholas Doe · Rating 5 out of 5]

An interim public enquiry

This is a deeply insightful assessment of the world's response to the pandemic, written by someone closely involved in the national and international groups responsible for that response.

Free of political spin, it clearly explores the successes and failures , attributes credit where it is due and calls out failures in leadership and policy without fear or favour.

In the absence of a timely and effective public enquiry to date, this analysis should serve as a reference document to how we must respond to be prepared for future pandemic threats.

[Antonio · Rating 5 out of 5]

An independent account of the UK response to the coronavirus pandemic by SAGE (main UK advisory body for emergencies) advisor and Wellcome Trust director Jeremy Farrar. Through very honest recollections, Farrar highlights all the rights and wrongs in the government response, including a self-reflection of what SAGE could where the government deviated from scientific advice but kept the mantra that it was "following the science". Sometimes the book is so thrilling that it reads like fiction, except that it wasn't: it was real life right there!

[Claire Dellar · Rating 5 out of 5]

Essential reading

Thank you, Sir Jeremy, for giving us such a clear and critical insight into the events of the pandemic so far. I now have a clearer understanding of the source of the confusion and stupidity I was seeing working at the next level down of the national pandemic response. So we weren't imagining it! Important validation for millions who worked to keep health and care afloat. Thank you for being our champion and speaking truth and reason to power. Next we must work to get your recommendations implemented.

[Tiffani · Rating 4 out of 5]

It took me exactly 2 days to finish the book. Unexpectedly fast for someone like me. Why? I had to skip a lot of pages. I just couldn’t force myself to read every detail or conversation the author had with his colleagues.

At first, the book tells a good back story of how pieces of information were being processed or somehow kept in the dark before they were released to public. Later, the book will talk about how the UK government had been dealing with the virus. Recommended for those who want to know more about the latter.