By Matthew E. Milliken
MEMwrites.wordpress.com
July 30, 2021
Although the world is still beset by Covid-19, even in nations where wide swaths of the population have been vaccinated, the publishing world began to produce volumes on the pandemic last year. One of the first to appear, in October, was Apollo’s Arrow: The Profound and Enduring Impact of Coronavirus on the Way We Live. Its author, Nicholas A. Christakis, is a physician and sociologist. He has appointments to five different departments in addition to other positions that he holds at Yale University.
Christakis approaches the pandemic like the polymath he is. The book begins with a passage from Homer’s Iliad in which Apollo unleashes a plague that spreads from mules and dogs to the army of Greeks besieging Troy. The text then walks readers through China’s discovery of a cluster of severe acute respiratory syndrome cases in Wuhan. Officials initially attempted to suppress or ignore information on the illness before acknowledging, at the end of December 2019, that they were facing a serious problem.
To their credit, China responded with what Christakis calls “the largest imposition of public health measures in human history,” including the placement of toothpick dispensers in elevators so passengers could push buttons without exchanging germs. By April, the nation seemed to have successfully suppressed the disease:
[T]he enormous reduction in cases once China mobilized to control the epidemic was an astonishing achievement from a public health point of view, even if some of the Chinese numbers were fuzzy.
To be clear, China, and other countries that subsequently implemented their own lockdowns, had not eradicated the virus; it had merely temporarily stopped its spread. When the lockdowns were lifted, the virus would come back.
My personal involvement with COVID-19 research began the day after Wuhan initiated its lockdown. On January 24, I was contacted by some Chinese colleagues with whom I had been collaborating for several years, analyzing mobile-phone data from China. Previously, we had been looking at how high-speed rail lines and earthquakes reshaped how people interacted with one another to form social networks, a topic of interest to me since 2001. Maybe, we thought in late January 2020, we could use similar data to study the burgeoning epidemic. As a result, I began to concentrate on what was happening in China. And I became increasingly alarmed. I realized that COVID-19 was not going to be an epidemic solely in China. It would be a serious pandemic of historic proportions.
As I was studying all these things happening in China, I began to realize that the inundated hospitals, the lockdowns, the homeschooling, the Plexiglas partitions, even the toothpicks would all be coming to the United States before long. I could not think of a reason they would not. But when I tried to sound the alarm in my own household in early February, my wife, who usually takes me reasonably seriously, thought I was having prepper fantasies.
Christakis dutifully tracks the virus’s inevitable progress. On Jan. 20, the first case of Covid-19 in the U.S. was diagnosed in Snohomish, Wash. (That patient does not seem to have infected anyone else.) The following month, the U.S. suffered its first serious outbreak, at the Life Care Center nursing home in Kirkland, Wash.; by late March, two-thirds of the center’s residential population, 50 health-care workers and 16 visitors had come down with the novel coronavirus, for a total of 167 cases, with at least 35 fatalities. On March 25, the Worldometer website reported 68,673 Covid-19 cases and 1,028 Covid-19 deaths in the U.S. By this point, the disease had already devastated places in Italy and Iran.
Of course, the book documents some of the claims made by President Donald Trump, which proved to be neither accurate nor prescient. For example:
In addition to denying the threat of the virus, Trump promoted misinformation about other essential responses to the crisis. On March 2, 2020, Trump claimed that a vaccine would be ready “over the next few months,” although, in reality, the timeline would be considerably longer. On March 6, Trump falsely insisted that “anyone who wants a test can get a test” despite widespread frustration among doctors and patients regarding the manifestly insufficient supply of such tests. He repeated such statements often, noting the “beautiful” and abundant testing and boasting about American superiority while failing to compare testing rates in other countries on a per capita basis.
Apollo’s Arrow is about as up-to-the-moment as a book can be. Christakis completed his text in August 2020, and his extensive footnotes even cites this September 2020 article on the D614G mutation in the novel coronavirus spike’s, a feature of the fast-spreading delta strain. Christakis is mildly (and wrongly, in my view) disapproving of the national and global Black Lives Matter protests that occurred after George Floyd was murdered by a Minneapolis policeman in full daylight on Memorial Day. The author acknowledges that “most of the protesters wore masks and the protests were outdoors, which is much less risky,” yet he drily observes, “[T]he virus does not care whether our reason for assembling is a protest, a funeral or a parade.”
Christakis touches on such topics as the link between race, socioeconomic standing and infections (“Most low-income jobs cannot be done remotely,” he notes), the challenges of virtual schooling (he tells of a University of Florida student who vomited at the desk in her bedroom while taking a test for which bathroom breaks were not permitted), and the partisan divide on science and public-health (he cites an April 2020 survey finding that Democrats were more likely to comply with safety measures such as wearing masks and avoiding crowds). The author writes with admirable clarity and gracefully moves from topic to topic.
But Apollo’s Arrow is more than a review of recent events. The author delves into different aspects of contagious diseases, one being the mismatch period, or the interval between when an ill person becomes capable of infecting someone else and when she or he begins displaying symptoms of the disease. The novel coronavirus’s positive mismatch period means that Covid-19 victims can pass on the virus before knowing they’re sick.
Christakis also notes that the SARS-2 or SARS-CoV-2 coronavirus, which causes Covid-19, is in many ways worse than its cousin, the SARS-1 coronavirus, which caused the significantly smaller SARS pandemic of 2003. The older bug is deadlier — SARS had a case fatality rate of around 10.9 percent, as opposed to Covid-19, which has claimed the lives of close to 1.8 percent of all infectees in the United States, per my interpretation of New York Times data. Because Covid-19 spreads so much more widely than SARS, and causes serious symptoms in a nontrivial fraction of those who survive the ailment, it is much more serious than its predecessor. (There were fewer than 10,000 identified cases of SARS.)
Apollo’s Arrow further delves into earlier mass disease outbreaks, including the bubonic plague, which may have killed 200 million people over the course of 14 centuries, and which led to the creation of the quarantine. He also explores the 1918 global flu pandemic, which killed anywhere from 39 million to 100 million victims, and which forced public officials in the U.S. to contemplate many of the difficult decisions about containment measures that have arisen during the current pandemic.
In all, Christakis’s volume is a fascinating and deeply researched overview of Covid-19.
New Yorker journalist Lawrence Wright gained some notoriety when his second novel came out in May 2020. The End of October describes a flu pandemic that devastates the world over the course of several waves. It naturally resonated with a terrified public.
In December, The New Yorker printed a two-part article by Wright that chronicled the last year of the first term of the Trump presidency, focusing on the disease that was ravaging the nation and world. The Plague Year: America in the Time of Covid, which was published in June, is an expanded version of that article.
Like Christakis’s work, The Plague Year recapitulates the beginnings of the Covid-19 outbreak, compares it to SARS, discusses Trumpian fabrication and negligence, and examines the disease’s disparate racial impact. But whereas Apollo’s Arrow was an academic’s book, The Plague Year is the work of a journalist. The newer text contains far less sociology and medical history and far more current events.
Unlike Christakis, who relies on news accounts for much of his coverage of government action, Wright gives readers a window into the upper levels of the Trump White House. Part of his insight comes from interviews with governors who, it seemed, frequently struggled to get useful assistance from the administration. Their perspectives inform this account of a March 2020 conference call that appears in a chapter titled “The No Plan Plan”:
“We’re marshaling the full power of the federal government,” [Trump] said. “We’re backing you one hundred percent.” Then he explained what he actually meant. “We’re backing you in terms of equipment and getting what you need. Also, though, respirators, ventilators, all the equipment — try getting it yourselves. We will be backing you but try getting it yourselves… Much more direct.”
It took a moment for this to sink in. Most governors had assumed that, just as in the event of a natural disaster — a hurricane or a forest fire — the federal government would rush to help. Federal action. The doors of the national stockpile would be thrown open and emergency equipment would be quickly dispersed. The governors had become aware of the shortages that might endanger the lives of their citizens — not enough ventilators, N95 masks, nasal swabs — vital weapons in the war against this virus. They expected the president to invoke the Defense Production Act, forcing private industry to produce whatever was needed. Surely, there was a national plan.
Jay Inslee, the Democratic governor of Washington State, was flabbergasted when he realized that the president did not intend to mobilize the forces of the federal government. Inslee told the president, “That would be equivalent to Frankly Delano Roosevelt on Dec. 8, 1941, saying ‘Good luck, Connecticut, you go build the battleships.’”
Trump responded, “Well, we’re just the backup.”
“Mr. President, I don’t want you to be the backup quarterback here,” Inslee said. “We need you to be Tom Brady. We need leadership. We need mobilization. We need to bring all the forces of government to bear on this existential crisis.”
Larry Hogan, the Republican governor of Maryland, was incensed. “You’re actively setting us up!” he told the president.
Gretchen Whitmer, the Democratic governor of Michigan, was stunned by how quickly the cases had exploded in her state since the first two were reported only five days earlier. Detroit hospitals were quickly at full capacity. When she hung up the phone from talking with Trump, she realized that, not only would there be no help coming from the federal government, Michigan was already practically out of masks for healthcare workers, not just for a day or a weekend — some healthcare workers didn’t have enough PPE [personal protective equipment] for their next shift.
Trump later defended his stance to reporters. “The federal government is not supposed to be out there buying vast amounts of items and then shipping,” he said. “You know, we’re not a shipping clerk.”
States scrambled to purchase necessities. Not only did they often find themselves placing competing bids, they discovered that their purchases were sometimes seized by federal authorities. Wright documents three cases in which states pulled strings to obtain supplies and either hid their plans from the Trump administration or stored their goods in secret locations to prevent confiscation.
In another instance, Rhode Island Gov. Gina Raimondo, a Democrat, was initially elated when a Federal Emergency Management Agency shipment of much-needed PPE arrived. “Hallelujah! I called my director of health. ‘Great news, the truck is finally here!’ She says, ‘Governor, it’s an empty truck. They sent an empty truck.’” Some shipping clerk, Mr. President.
(Wright does not note that prior to the pandemic, Trump diverted around $165 million in FEMA money to deal with immigration-related issues, a move that likely did not enhance the agency’s emergency-response capacity.)
The Plague Year also describes the cluster of Covid-19 infections that arose after a largely unmasked group gathered for indoors and outdoors socializing at the White House following Trump’s nomination of Amy Coney Barrett to fill the seat of recently deceased Supreme Court Associate Justice Ruth Bader Ginsburg. The author concludes that Donald or Melania Trump were the most likely vectors:
Some Covid carriers can go as long as two weeks before they start to show symptoms, and without knowing when the president last tested negative, it’s impossible to know when he contracted the disease and how many other people he might have infected.
More than a dozen guests … would soon test positive. All had been negative when they arrived, and none wore a mask. The only people in the Rose Garden who might not have been tested were the president and the first lady.
The audience returned to their lives, some carrying the virus with them. The White House ignored the CDC’s request to do contact tracing, saying that it would be done internally, but … attendees said they had not been contacted. The full extent of the contagion from the Rose Garden cluster will never be known.
Despite all this, Wright at times seems determined to give the president a fair shake. He quotes a government source’s speculative assessment that “if Trump hadn’t ended travel from Europe, there would be up to a million dead Americans.” This would be more convincing had Trump’s bans prevented Americans from returning home — they were admitted into the country — or if returning travelers had been properly screened or isolated — they were not.
The author also writes that Operation Warp Speed, the vaccine development program, “may prove to be the Trump administration’s most notable success in the pandemic,” which is probably true. However, he then suggests that the first Covid-19 vaccine to be granted an emergency use authorization by the Food and Drug Administration, the Pfizer jab, was part of the program. It was not.
In some ways, the most interesting parts of The Plague Year are early passages exploring two aspects of the pandemic response. One of these is the nation’s failure to produce accurate Covid-19 tests at scale as the dangerous disease reached American shores.
Wright describes a series of missteps by the Centers for Disease Control. The agency decided to make the tests itself, an endeavor that was far beyond its normal scope of activity. Perhaps as a result, in one laboratory, “researchers were analyzing patient samples in the very same room where testing ingredients were assembled.” When the extremely sensitive tests were distributed, public health labs around the nation quickly found that “the tests were turning up false positives at an alarming rate.” The tests weren’t wrong, exactly; the issue was that the virus they were detecting was often present not in the samples being tested but in the test kits themselves.
Also of interest is Wright’s account of decades of research that allowed Barney Graham, an official who worked for Dr. Anthony Fauci at the National Institutes of Health, and his team to design a Covid-19 vaccine in record time. Years of attempts to understand and combat the flu, various coronaviruses and an obscure but deadly pathogen called respiratory syncytial virus, or RSV, helped scientists understand how to train immune systems to fend off diseases without being exposed to a deadly agent. “Science is all about making incremental advances toward a larger goal,” Graham tells the author while lamenting that vaccine development funding is only intermittent. (This is a pattern that can and should be fixed.) Graham also observes, “Almost every aspect of my life has come together in this outbreak.”
As mentioned, Wright is more concerned with day-to-day events than Christakis. He devotes a few pages to Michael Caputo, a friend of Roger Stone who, like his pal, was investigated for being a 2016 Trump associate with connections to Russia. Caputo was picked to oversee communications at the U.S. Department of Health and Human Services in April 2020, “when the disease was spreading out of hand and transparency and competence were needed to restore public trust. Instead, Trump chose a man with no expertise in science or public health.”
Caputo embarked upon what became a “fruitless campaign” to “encourage celebrities to endorse the administration’s laissez-faire approach to the coronavirus.” Some $300 million — three hundred million dollars! — were requisitioned from the CDC’s budget for this effort. In September, Caputo gained notoriety for a rambling Facebook video in which he warned that ammunition would soon become hard to get and claimed that seditious scientists “are sacrificing lives in order to defeat Donald Trump. … This is war. Joe Biden is not going to concede.”
The sad and infuriating passage on Caputo transitions into details about a plot by armed Trump supporters to kidnap Michigan Gov. Whitmer. The conspirators were arrested before anyone was injured. Naturally, the president made this about himself and his profoundly callous approach to battling — or rather not battling — Covid-19: “Rather than say thank you, she calls me a White Supremacist,” he tweeted. “Governor Whitmer — open up your state, open up your schools, and open up your churches!”
For all that, the 2020 presidential campaign makes surprisingly little showing in The Plague Year. (When Biden limited his campaign appearances for reasons of personal and public health, many conservatives claimed that a senile and/or cowardly candidate was bunkering in his basement, a detail that I think speaks to our age of insane politics.) The book ends with a coda covering various events in January 2021, including the Jan. 6 Capitol riot and the creation of a memorial for pandemic victims at the Reflecting Pool, which President-Elect Joe Biden and Vice President-Elect Kamala Harris attended on the eve of their inauguration.
Of course, the pandemic was and remains a sprawling, worldwide event, and no single book can be everything to all people. Like Apollo’s Apple, The Plague Year is a worthy chronicle of a deadly disaster. Both volumes are solidly written and should offer future generations valuable insights into a disaster of historic proportions. That said, Christakis’s work is likely best suited to readers who crave an intellectual assessment of the phenomenon, while Wright’s will appeal more to those who prefer a more grounded approach.
MEMwrites 
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