The events of the past three years have caused millions across the globe to increase their knowledge base regarding an understanding of infectious pathogens. Older books on pandemics have again popped up on bookstore shelves, and one of those books is Laurie Garrett’s 1994 book The Coming Plague.
Just what is it about this book that helped to truly bring the conversation about the threat of emerging pandemic disease to life? How did this book help to drag pandemic threats to the limelight? Let’s take a detailed look.
TABLE OF CONTENTS
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01
The Birth of a Writer
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02
Within the Pages
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03
The Impact of The Coming Plague
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04
Frequently Asked Questions
The Birth of a Writer
Garrett had always had an interest in the study of life. It was hard for her to look at the world around her without insatiable curiosity taking a firm grip on her mind. This curiosity led her to get her B.S. in biology from Merrill College in 1975.
Image courtesy of Ben P. (Image courtesy of Wikimedia Commons.)
But it wasn’t enough. Laurie Garrett wanted to know more. And it was this quest to learn more that eventually led to the step that would birth a book that would soon revolutionize a particular field of study – pandemics.
To fulfill this desire, Garrett enrolled in the Ph.D. program at the University of California, Berkeley, in the department of bacteriology and immunology. She was working with the top minds in the field, learning what it took to stop disease better.
It was the 1980s, a happy time for the United States.
Things seemed as if they were looking up no matter where one looked. The economy was booming, advancements in science were growing by leaps and bounds, and people seemed happy.
Part of this happiness stemmed from what was happening within medicine. The age of the antibiotic was in its heyday, and to many, it seemed as if the age of infectious disease was over. Viruses, bacteria, parasites – they were all conquered, weren’t they? – and the world was more than willing to etch the dates on the tombstone. Because of this, science had shifted its focus to trying to conquer heart disease, Parkinson’s, and the many other chronic illnesses that the world was disabled with.
Penicillin being produced in the lab.
This focus shift understandably led to the development of certain taboos within the scientific community. One of these unspoken rules was that even raising the discussion about the potential of future pandemics seemed fundamentally absurd. To note that this was still a possible happenstance was enough to classify one as a loon – a social pariah without a finger on the pulse of how things were working in the world.
If you wanted to be viewed as Chicken Little, that’s what you did. You talked about contagion.
The pendulum had swung so far in this direction that medical school students at the time were often discouraged from going into infectious disease research. They were told things such as, “It’s a dying field. We’ve got vaccines and antibiotics, and everything is under control.” And this was when Laurie Garrett began to study the threat of future pandemic disease.
Legionnaire’s Disease
The year was 1976; it had been 200 years since America won independence from England. Massive celebrations rocked the United States, and one of these celebrations was taking place at the Bellevue-Stratford Hotel in Philadelphia. Among those celebrants were 600 Pennsylvania State American Legion members – a collection of war veterans and their families.
The Bellevue-Stratford.
The day after arriving at the hotel, several of the Legionnaires began to grow ill, showing classic signs and symptoms of having developed pneumonia. Then, on July 27, the first death took place. By the time the dust settled about a month later, 221 people had become ill with a mysterious new virus that had killed 34.
What had they died from? A novel infectious agent – L. pneumophila – was the cause of Legionnaire’s disease.
L. pneumophila
The newfound disease didn’t just give birth to a new illness for the world to cope with; it also rocked the scientific community, causing them to pay attention.
And one of the people it caused to shift their gaze was none other than Laurie Garrett. While Garrett had randomly begun collecting newspaper clippings on the various epidemics that the world was starting to see pop up all over the place before Legionnaire’s, this outbreak seemingly manifested out of thin air overnight and grabbed her attention.
This collection of newspaper reports morphed into a proper study of the issue in the 1980s. While the rest of the world largely seemed to be ignoring the world of infectious disease, isolated epidemics were starting to cause more and more people to scratch their heads in wonder.
And then came AIDS.
The AIDS Crisis
First discovered in the 1980s, AIDS was a source of global fear. Suddenly, there was a novel disease that nobody had ever seen before, causing people to die from the simplest of infections. Nobody knew where it came from, how it was contracted, or what the treatment options were.
All everybody knew was that AIDS was killing people worldwide, and things seemed unstoppable. AIDS turned the medical world over on its head. The National Academy of Sciences called a special convention in the late 1980s to address this. Just what was going on? Where were all of these novel epidemics coming from? And could humanity still proclaim that the reign of infectious disease was over?
It didn’t appear so.
And Laurie Garret’s research intensified.
Aside from attending just about every AIDS conference in the United States held at that time as a journalist for Newsday, Garrett also decided to further her education by getting her Ph.D., as mentioned above. But then, she went a step further.
From 1992-1993, Laurie Garrett was a fellow at the Harvard School of Public Health. This school is regarded as the best in the world of public health. While to have the name “Harvard” on a resume is always a note of distinction, within the public health microcosm, this is particularly so.
Harvard School of Public Health. (Image source: Image courtesy of Wikimedia Commons.)
You attend Duke to be a medical doctor, the University of Notre Dame to study architecture, and Harvard to study public health. They are the leaders in their respective fields.
And it was because of this that Garrett gained access to some of the top immunologists in the world. While working in the emerging diseases department, she was able to converse with noted researchers Mary Wilson, Uwe Brinkman, and Andrew Spielman.
A NOTE OF INTEREST
Mary Wilson is well-known for her research into antibiotic-resistant pathogens. She believes that the age of easy antibiotic discovery is over due to novel resistant strains developing that we don’t seem to be able to stop.
She wrote Antibiotics: What Everyone Needs to Know and A World Guide to Infections: Diseases, Distribution, Diagnosis. The latter is a massive text that helps physicians decipher what disease may be showcased in a traveler just back from international adventures.
Uwe Brinkman died of a heart attack in 1993 while conducting research in Brazil. He was an epidemiologist and avid researcher in the field of tropical diseases. Laurie Garrett’s last year as a fellow at Harvard was when Brinkman died.
Andrew Spielman was a researcher who focused on vector-borne diseases (diseases passed by insects to humans). He co-wrote Mosquito: A Natural History of Our Most Persistent and Deadly Foe and discovered that the explosion in Lyme disease was attributed mainly to the whitetail deer population.
He also discovered that Lyme could be reduced by leaving toilet paper tubes full of pesticide cotton balls throughout an area. White-footed mice would use the cotton as nest material, and the pesticide would kill all the larval ticks nestled in their fur. He died in 2006.
During this time, while she was at Harvard, Garrett wrote the bulk of her 750-page book The Coming Plague: Newly Emerging Diseases in a World Out of Balance. It took a monumental effort as she had to balance her time between writing and researching the book, working on her fellowship at Harvard, while also working a job writing pieces for Newsday. But after ten years of work on the project, her book was ready for publication.
The book was an instant hit. People were still afraid of AIDS, which created an environment that caused the sales of this book to prosper. Ignorance breeds fear, and nobody likes being afraid. But everybody was worried, so they strove to harvest as much information on pandemic disease as possible.
The result? Outrageous sales of The Coming Plague.
For 19 weeks, Garrett’s decade-long work rested atop the New York Times bestseller list.
Within the Pages
The reason The Coming Plague is such a brick of a book is due to the scope it covers. Garrett is a journalist, and the book is written in a journalism style. Personal interviews abound within the book as she converses with experts in hantaviruses, sexually transmitted diseases, toxic shock syndrome, Ebola, and more.
Anybody looking for great detail into the origins of several infectious diseases out there would be served well by reading Garrett’s work. They will learn more about where many infectious diseases come from and some of the factors that contribute to their rapid spread.
For example, Garrett takes a deep dive into the public health aspects surrounding a number of outbreaks, such as cholera, on an international scale. When public drinking water is adequately sanitized, cholera cases plummet to almost undetectable levels.
Cholera.
Garrett also notes how the rise in international travel and the increasing amounts of imported foods can play a massive role in spreading infectious diseases. Once upon a time, the case was that only the wealthy could travel abroad. International travel was something that only rich people did. Now, it’s not uncommon to find college students who spend their free time waiting tables heading to Italy on spring break.
More people travel than ever before, and they’re able to do so much faster than ever before. It took the Pilgrims months to journey from Europe to Plymouth Rock. During this time, any infectious disease found with the Pilgrims would have run its course throughout the time on the ship. The chances of still being able to spread an infectious disease such as the flu months after everybody had been exposed to it would have been minimal.
A NOTE OF INTEREST
Garret was in India during the 1994 outbreak of bubonic plague there. She noted that it was commonplace for the doctors and pharmacists in cities to disappear during this time as they didn’t want to get sick.
One could make arguments about smallpox being brought to The New World here, but the point is that longer travel times diminished the risk of pandemic disease.
Suppose a novel form of Ebola were to pop up in Zaire tomorrow – an aerosolized version. If that were to happen – and many researchers fear the day that this could happen – something from Zaire could find its way to the United States in less than a day. A trip that took months 200 years ago can now be accomplished in 12 or so hours on a plane.
Ebola containment unit.
Somebody with zero signs or symptoms of the new, aerosolized Ebola could quickly develop a cough and fever a few days after their arrival in Boston. From there, further spread would take place. So, if you don’t think that faster travel speeds don’t also result in easier disease transmission, you may want to read The Coming Plague.
It’s not just human agents that can spread disease easier due to faster travel speeds. Imported food is also a potential threat.
As Garrett points out within the text, a lot of the food that Americans eat is imported from overseas, with a lot of this food coming from nations with little to no health regulations. For example, it wasn’t that long ago when an outbreak of hepatitis within the United States was traced back to strawberries from Egypt.
Manure spraying in a field is a common farming practice that can lead to contamination if performed on crops almost ready to harvest. (Image source: Image courtesy of Gordon Hatton at Wikimedia Commons.)
With longer travel times, there was zero chance that a shipment of contaminated strawberries would have stayed fresh on a journey from Egypt to the United States. Fast travel, newer refrigeration technologies, and chemicals now permit that. (Foodborne threats are a great reason to consider adding a MIRA Safety Detoxifier to your family’s kitchen.)
While there is much that one can easily argue against that Garrett advocates for, one must remember that this book was published in 1994 and researched during the 1980s. A lot of science has changed since then. Secondly, just because one disagrees with a few premises that somebody discusses does not mean there is a complete lack of value in everything somebody says.
You may disagree with Albert Einstein’s philosophy on some subjects, but that by no means indicates that his contributions to nuclear warfare are nonexistent. In the same manner, there is still value in this older book.
The Impact of The Coming Plague
Books can have an impact. Richard Preston’s The Hot Zone brought awareness of Ebola to the United States. William McNeill’s Plagues and Peoples (a book The Coming Plague is often compared to) showcased how plagues are to be expected. It should be no surprise then that The Coming Plague also had a massive impact.
AIDS made discussing global pandemics not cause all involved parties to appear as a collection of loons. The Coming Plague can’t claim that “honor.” What TCP did do, however, was give people the boots-on-the-ground information they needed to see that, yes, there were a lot of potential pandemic threats at the time, and a lot of questions were beginning to raise their ugly heads.
(Image source: Image courtesy of Kris Krug at Wikimedia Commons)
Garrett brought these questions to a broader audience than they would have been available to otherwise. When engineers get injured, the world gets better medical devices. They may not technically be involved in the health field at all, but a question has been brought to their attention that could be remedied using their specific set of skills.
A NOTE OF INTEREST
If she hadn’t chosen to become a journalist, Garret would have most likely gone on to become an AIDS researcher and work as a professor.
For example, take this editorial where an injured engineer used his particular set of skills and knowledge base to question the presiding health advice at the time. Cardiac patients at the hospital this engineer attended were often told not to lift more than four pounds after surgery. Then, the patients had to open a door with a 14-pound pull to gain access to cardiac rehab. His conclusions are fantastic.
But it took an outsider to reach those conclusions.
In the same way, Garrett’s The Coming Plague brought questions to a broader audience.
The Book is Closed
Garrett astutely pointed out in 1994 that infectious diseases will always be with us. To fall into complacency because of recent scientific advancements, as people did in the ‘60s - early ‘80s, is a mistake that can lead to severe consequences on a population scale.
I read this book back in graduate school while working on my master’s in public health many years ago and found what Garrett had to say here incredibly informative.
So, pick up a copy and glean what you can. But ultimately, I think it’s important not to forget Garrett’s more significant point throughout the text; that not only can society not afford to grow complacent when it comes to infectious disease, but proper planning ahead of time is a worthwhile expenditure of time as well.
On the personal level, part of this proper planning means that you are taking steps to ensure your family has the necessary levels of PPE.
As Garrett says, not only are there novel infectious agents that we are discovering daily but there are malevolent actors out there, such as those with Biopreparat, who are actively engaged in creating new biological threats as well.
In either case, MIRA Safety is a great way to ensure that your family is prepared for infectious diseases. We sell a variety of high-quality gas masks and filters, such as our CM-6M and the NBC-77 filter, that do a superior job in helping to keep you safe from infections compared to other gas masks and filters that are out on the market.
The MIRA Safety CM-6M at work.
So grab a copy of The Coming Plague and pick up a gas mask. You won’t regret either move and will leave the day better prepared for what may lie ahead. As Garret notes, preparedness begins with understanding, and reading her book will help you better understand some of the potential threats out there.
What are your thoughts on the subject? Have you read The Coming Plague? Did you like it? Please tell us what you’re thinking in the comment section below.