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The Premonition: A Pandemic Story

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For those who could read between the lines, the censored news out of China was terrifying. But the president insisted there was nothing to worry about.

Fortunately, we are still a nation of skeptics. Fortunately, there are those among us who study pandemics and are willing to look unflinchingly at worst-case scenarios. Michael Lewis’s taut and brilliant nonfiction thriller pits a band of medical visionaries against the wall of ignorance that was the official response of the Trump administration to the outbreak of COVID-19.

The characters you will meet in these pages are as fascinating as they are unexpected. A thirteen-year-old girl’s science project on transmission of an airborne pathogen develops into a very grown-up model of disease control. A local public-health officer uses her worm’s-eye view to see what the CDC misses, and reveals great truths about American society. A secret team of dissenting doctors, nicknamed the Wolverines, has everything necessary to fight the pandemic: brilliant backgrounds, world-class labs, prior experience with the pandemic scares of bird flu and swine flu…everything, that is, except official permission to implement their work.

Michael Lewis is not shy about calling these people heroes for their refusal to follow directives that they know to be based on misinformation and bad science. Even the internet, as crucial as it is to their exchange of ideas, poses a risk to them. They never know for sure who else might be listening in.

304 pages, Hardcover

First published May 4, 2021

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About the author

Michael Lewis

45 books12.2k followers
Michael Lewis, the best-selling author of Liar’s Poker, The Money Culture, The New New Thing, Moneyball, The Blind Side, Panic, Home Game, The Big Short, and Boomerang, among other works, lives in Berkeley, California, with his wife and three children.

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Displaying 1 - 30 of 3,785 reviews
Profile Image for Michael Perkins.
Author 6 books344 followers
March 23, 2023
Damn straight!

“There is no incentive to prevent things,” Lewis says. “If you look at what our two societies have in common, we’ve given ourselves over to markets in a way that’s pretty extreme. Which is to say, we strongly encourage things that pay and we give correspondingly less attention to things that don’t pay. Prevention does not pay. Disease pays. It pays when Covid is all over society and corporations get to make a lot of money testing for it. It doesn’t pay just to shut it down up front. And if there’s food for thought, it’s that we were essentially incentivised to have a bad pandemic response.”

-Michael Lewis


Still not prepared for the next one....



This book is not going to be ranked with the author’s best books, such as Moneyball and The Big Short, but it was interesting nevertheless.

There’s a certain irony that Trump trolls and Libertarians have attacked this book, when Trump is hardly mentioned and the main villain is the CDC, a villain you’d think these critics would approve of. The book is also pretty tough on Democratic California Governor, Gavin Newsom. Of course, this would mean actually reading the book to find this out, which I doubt most of the trolls did.

What’s different is that Lewis conveys an element of advocacy and even anger you don’t see in his other books. I do hope the history books get it right about how the U.S. response was botched.

The watchword for these diseases is “early detection, early response.” Containing these diseases in their infancy is critical.

You may recall that at some point Mike Pence was put in charge of the Covid effort, which showed that Trump didn’t take it seriously. Pence's solution was to have prayer meetings.

Going back to the Reagan era, the head of the CDC had become a political appointee. Pence, an Evangelical, favored hiring Evangelicals which in this case included Deborah Bix and Robert Redfield. Both showed some serious lapses of judgment.

For example, after Covid broke out in China, numerous Americans flew home from there. Redfield was urged to test these folks when they arrived with a possible quarantine, but he refused, saying he was not going to treat them as “prisoners.” So they were free to blend into the general population and spread the disease.

For all his criticisms of public health agencies, Lewis should have included a section on how grossly underfunded public health is in the U.S.


Excellent, more detailed review of the book....

“There is no incentive to prevent things,” Lewis says. “If you look at what our two societies have in common, we’ve given ourselves over to markets in a way that’s pretty extreme. Which is to say, we strongly encourage things that pay and we give correspondingly less attention to things that don’t pay. Prevention does not pay. Disease pays. It pays when Covid is all over society and corporations get to make a lot of money testing for it. It doesn’t pay just to shut it down up front. And if there’s food for thought, it’s that we were essentially incentivised to have a bad pandemic response.”


Profile Image for Libby.
575 reviews157 followers
June 23, 2021
Michael Lewis held my attention in this riveting account about how the US met the threat of Covid19, a virus that made 2020 the most challenging year that many of us had ever faced. This book gave me an inside look into ways in which our healthcare system failed in the most difficult crisis they had faced since the 1918 flu epidemic. However, Lewis also documents many valiant men and women who faced the crisis head-on, with courage and intelligence. Unfortunately, many of them met with bureaucratic roadblocks that stymied their progress.

It was worth reading the book just to gain a more complete understanding of the role of the CDC during the pandemic. What I gathered made me conclude that the CDC is excellent for after-the-fact studies and data collecting, but as foot soldiers on the frontlines in a war with a disease, there were huge deficiencies. Lewis includes some of the history of the CDC, back to the resignation of CDC Director David Sencer in 1976 after a debacle over the swine flu vaccine. This helped me understand why the CDC is the way it is and the need for brave people who are not yes-people to lead this vital institution. Currently, the Director is a Presidential appointee. Lewis seems to think it operated better when the Director rose through the ranks and was put forward by colleagues.

It was thanks to President George W. Bush, in 2005, reading The Great Influenza: The Story of the Deadliest Pandemic in History by John M. Barry, a story about the 1918 flu epidemic, that the US had a pandemic plan at all. It drove President Bush bonkers that there was as he put it, no “whole-of-society plan.” Congress agreed to allocate $7.1 billion to President Bush for pandemic strategy. The story of the team put together by Rajeev Venkayya, special assistant to the US President for biodefense, makes for fascinating reading. Physicians Richard Hatchett and Carter Mecher were two members of the seven-person team. Mecher had an incredible ability to think outside the box, and became invested in the accounts of Philadelphia during the 1918 flu epidemic. Others had concluded that infection control and social distancing were ineffective due to what had happened in Philadelphia but Mecher realized that Philadelphia’s actions were too little too late. Timing was of the essence.

Michael Lewis is also the author of ‘The Blind Side’ and ‘The Big Short’ and other books. He has a very natural storytelling ability that is engaging. There are many side stories in this book, but they connect to the whole in satisfying ways. For example, the exponential growth potential of the most transmissible viruses, Hatchett and Mecher, compared to the Mann Gulch fire in Montana in 1949. Fifteen fire-fighting young men parachuted into the area, hiking down into Mann Gulch with packs and axes. They believed the fire burned on the other side of the creek that they were hiking toward. When they neared the river, they were horrified to find the fire had jumped the river and was moving toward them at a terrifying speed. Ten of the men burned to death that day, two more would die later from their injuries. Carter was transfixed by what one of the men, Wag Dodge, had done to survive. He had lit a second fire. “As his fire burned the grass in front of him, he walked into it and threw himself onto the hot ashes...Dodge alone heard and felt the main fire passing by on either side of him, leaving him unscathed.” Carter related this to a pandemic, and came to several conclusions, one of them being, “You cannot wait for the smoke to clear; once you can see things clearly it is already too late,” and another, "Figure out the equivalent of an escape fire."
Profile Image for Olive Fellows (abookolive).
567 reviews4,600 followers
December 10, 2021
Click here to hear my thoughts on this book over on my Booktube channel, abookolive.

There are going to be a lot of pandemic books coming out in the coming months, but this is one that tells a story that was not exactly mainstream in 2020. In this book, Michael Lewis (in his typical fashion) talks about a small group of people who worked in or around public health and who had ideas about how to respond to the growing COVID threat, but really struggled to be heard. Like Lewis always seems to achieve, he takes a story we've all just lived through and turns it into a page-turning thriller.
Profile Image for Barbara K..
378 reviews67 followers
September 17, 2022
This has been on my bookshelf for a couple of months, and I picked it up this week because I wanted a reliable read. Something I could be pretty sure I would find worth my time.

And wow, was it ever! I've been a Michael Lewis fan going all the back to his first book, Liar's Poker, and this is one of his best. The topic is timely (sadly, we are still still in a pandemic) and a question lingering in the air is, "How could our response to this crisis have fallen so miserably short of the mark?"

Lewis provides an answer, at least in part, by using his gift for dissecting a complex situation and turning it into a comprehensible story. As he so often does, he achieves this by introducing us to individuals who have personal insights into the problem that result in their becoming involved at some level. The people he features in this book come across as heroes who struggle to overcome systemic hurdles - and landmines - in hopes of saving lives from the worst ravages of the looming pandemic.

The institutions in this book by and large come off less well. From an organization dedicated to responding to public health crises in real time, the CDC has devolved over the past 40 years into, in the words of one of the heroes, the "Center for Disease Observation". Ronald Reagan gave it a strong push in that direction by politicizing the top role.

George W. Bush, by contrast, is presented as a hero. After reading a book about the 1918 flu, he became convinced that the country needed a pandemic response, and set about establishing one that was pretty much shelved at the end of his administration. Obama didn't carry that torch as much as he should have, but made an attempt to learn from what happened with the CDC's swine flu response debacle in 1976 in order to be better prepared for the next round.

But it was Donald Trump's administration - particularly John Bolton in his role as National Security Adviser - who was responsible for completely derailing the potential for an organized response, when he determined that the only threats to the national security came from outside the country.

And so it came to people working outside any official framework to try to pull together a response to COVID 19. They spent much of their time crying in the wilderness, as their efforts to gain the attention of persons in the position of power or leadership were ignored. Their stories inspired in me both admiration for their efforts and sympathy for the frustration they experienced at every turn.

At the end of the day the book is a more detailed view of the sorry - and scary - condition of the US government that Lewis describes in broader strokes in The Fifth Risk: Undoing Democracy. In the hands of a less talented author it would be a hard message to digest. We can only hope that because Lewis makes his message so accessible, some of those people in positions of power or leadership will read the book, and learn something from it.
Profile Image for Roberta .
1,166 reviews22 followers
June 13, 2021
I absolutely looked forward to reading this book after reading Lewis' The Fifth Risk. It was spooky to read in that book, published in 2018, that "The basic role of government is to keep us safe" and one of the potential disasters on the list is "an airborne virus wiping out millions of people" (page 25).

Not quite what I expected but still deeply informative. There was more background of handling a pandemic than I expected and less blame given to Trump.
Profile Image for HBalikov.
1,715 reviews638 followers
June 4, 2022
Read this Book!
Most of us have many questions about the ongoing Covid pandemic. This book provides the context for most of those questions and raises a few questions of its own; particularly about the Centers for Disease Control and how they saw their roles and responsibilities.

Just as Americans were being repatriated from Wuhan, the government decided to only test those who were running a fever, even though other countries including Japan had already proved that a certain percentage of those infected did not manifest any fever: "Did they want to avoid finding cases to avoid displeasing Donald Trump? Were they concerned that, if they tested people without symptoms and they found the virus, they’d make a mockery of their current requirement that only people with symptoms be tested? Were they embarrassed or concerned that someone other than the CDC was doing the testing? If so, then why didn’t they just perform the tests themselves?" Thus, all Americans returning from Wuhan and were isolated, if they had no fever, were not tested before being released.

Here's how Lewis frames his focus: "During the first half of the Trump administration I’d written a book, The Fifth Risk, that framed the federal government as a manager of a portfolio of existential risks: natural disasters, nuclear weapons, financial panics, hostile foreigners, energy security, food security, and on and on and on. The federal government wasn’t just this faceless gray mass of two million people. Nor was it some well-coordinated deep state seeking to subvert the will of the people. It was a collection of experts, among them some real heroes, whom we neglected and abused at our peril. Yet we’d been neglecting and abusing them for more than a generation."

Some writers of non-fiction have a special gift of serving you an immense bowl of ideas and facts without making you gag on all of it. Tracy Kidder and John Krakauer are two of my favorites and Michael Lewis fits in nicely with them. Here, he acquaints readers with some of the people that you never heard about, but whose efforts were key to understanding and responding to this pandemic. I have to give this book my highest recommendation. 5*

Some of my favorite insights from this book:
"In February 2021, The Lancet published a long critique of the U.S. pandemic performance. By then 450,000 Americans had died. The Lancet pointed out that if the COVID death rate in the United States had simply tracked the average of the other six G7 nations, 180,000 of those people would still be alive. “Missing Americans,” they called them. But why stop there? Before the pandemic, a panel of public-health experts had judged the United States to be more prepared for a pandemic than other G7 nations. In a war with a virus, we were not expected merely to fare as well as other rich countries. We were expected to win."

Some of that blame was not due to political machinations but to governmental structure. Lewis calls out the Center for Disease Control (CDC) and its view of own role: "The CDC had lots of great people, but it was at heart a massive university. “A peacetime institution in a wartime environment,” Carter called it. Its people were good at figuring out precisely what had happened, but by the time they’d done it, the fighting was over. They had no interest in or aptitude for the sort of clairvoyance that was needed at the start of a pandemic."

"“All science is modeling. In all science you are abstracting from nature. The question is: is it a useful abstraction.” Useful, to Bob Glass, meant: Does it help solve a problem?"

"“The cost of a single TB case is between thirty and a hundred thousand dollars,” she said. “Higher if it is drug-resistant TB. So why are we haggling over a seventy-two-thousand-dollar machine?”"

"The decisions she was forced to make were less like, say, those made by a card counter at a blackjack table, and more like the ones made by a platoon leader in combat. She never had all the data she wanted or needed when making her decisions—enough so that afterward she could defend them by saying, “I just did what the numbers told me to do.”"

"If models could improve predictions about some basketball player’s value in a game, there was no reason they couldn’t do the same for the value of some new strategy in a pandemic."

"He didn’t ask his superiors at Sandia National Labs for permission, because he already knew the answer. “They kill people for doing that,” he said. “They would flip and put people in between me and them, and I wouldn’t be able to do anything.”"

"Richard couldn’t understand his certainty, or the weird conventional wisdom that had coalesced. “One thing that’s inarguably true is that if you got everyone and locked each of them in their own room and didn’t let them talk to anyone, you would not have any disease,” he said. “The question was can you do anything in the real world.” The new models of disease, slow and unwieldy though they were, gave Richard hope. D.A. Henderson, and the people at the CDC, along with pretty much everyone else in the public-health sector, thought that the models had nothing to offer; but they were missing the point. They, too, used models. They, too, depended on abstractions to inform their judgments. Those abstractions just happened to be inside their heads. Experts took the models in their minds as the essence of reality, but the biggest difference between their models and the ones inside the computer was that their models were less explicit and harder to check. Experts made all sorts of assumptions about the world, just as computer models did, but those assumptions were invisible. And there was every day fresh evidence that the models inside the minds of experts could be seriously flawed."

"The more Carter and Richard learned, the more excited they became. “Imagine if we could affect the weather,” Carter wrote, in one of his long memos. “Imagine if we had the capability to reduce a category 5 storm to a category 2 or a 1 . . . Now although the Federal Government is not at the threshold of significantly reducing the potency of a hurricane, it is at the threshold of doing just this to another natural disaster—pandemic influenza.”"

"He’d visited the CDC to explain the new genomic technology, only to be met with boredom and blank stares. In the Food and Drug Administration there was one woman—a single human being—trying to curate the academic literature so that doctors and patients could easily access new knowledge. She’d taken it upon herself; no one had asked her to do it. “It’s often individuals who pick up the baton, and they’re not even doing it as part of their day job description,” said Joe. “Scattered throughout those organizations there are these people, but they aren’t organized, trying to compensate for the deficiencies in the system.” The Red Phone could save your life if you called it in time. The system had configured itself in such a way that, more often than not, you didn’t."

"To inject a virus into an African python took some trouble. Snakes don’t have injectable veins. They do, perhaps surprisingly, have hearts, and that’s where the virus must be injected. Snake hearts don’t stay put, like human hearts, but travel up and down the snake’s body. To inject a snake’s heart with a virus requires two postdocs and one full professor: one to hold the snake in a death grip, one to use a Doppler radar to find the snake’s heart, and a third to plunge the needle into it."

"All of which was part of a bigger problem that he wanted to tackle: how any big government agency allocates its resources."
Profile Image for Kathleen.
1,301 reviews119 followers
May 18, 2021
Lewis has written an historical account of pandemic planning in the United States through the administrations of Bush, Obama and Trump. It ends up being a scathing indictment of the Centers for Disease Control and Prevention. The author highlights the shortcomings of the United States’ health system when facing a pandemic. By not having a centralized national health care system, the U.S. was not able to quickly put in place a pandemic response. [There was a modest-sized pandemic response unit put in place by the Bush administration, but was disbanded by 2020.]

Lewis focuses on the stories of a group of medical doctors and scientists who persevered to get the US to take the pandemic response seriously. This group of heroes were brilliant, dedicated, resourceful and conscientious. They understood all too well how unprepared America was to fight a pandemic. There was Charity Dean, a deputy director of California’s Department of Public Health. There were Richard Hatchett and Carter Mecher who had helped to shape pandemic planning in the George W. Bush administration, and worked tirelessly to mitigate the unfolding catastrophe. Lewis points to Joe DeRisi who developed an extremely useful technology for rapid viral testing—but was thwarted by institutional recalcitrance; and Bob Glass, a scientist whose 13-year-old daughter’s science fair project became the basis for the ‘social distancing’ model of disease control.

The irony is that institutions, like the CDC, that pursue an abundance of caution in the face of a pandemic amounts to a form of recklessness. More lives are lost. More lives damaged by the ravages of the disease. Highly recommend this fascinating account.
187 reviews1 follower
May 12, 2021
I was a bit disappointed by this book, as a big fan of the author. It feels like it was maybe rushed to print. The writing is, unsurprisingly, quite good. But it feels like there is no unique, core purpose or thesis for the book, unlike his prior work. It gets better in the second half, when he starts writing more about the coronavirus, but he doesn’t really bring the themes from the first half of the book into the second half, so it feels like two separate pieces rather than part of a narrative whole.
Profile Image for Melki.
5,676 reviews2,324 followers
August 13, 2021
- "Despite the White House spin attempts, this will go down as a colossal failure of the public health system of this country. The biggest challenge in a century and we let the country down. The public health texts of the future will use this as a lesson on how not to handle an infectious disease pandemic."

- "We know what the virus will do," she liked to say. "We don't know what the humans will do."

- "We are the bad example for the rest of the world."

True, this book was not as informative as The Fifth Risk: Undoing Democracy, because - let's face it - if you're reading this, you've lived through a year and a half of the Covid crisis, and you already know a lot of the information covered. And, in some ways, this title picks up the gist of Lewis's last book which was indeed a warning to Trump, and all future presidents - If you don't know what a particular agency actually does then don't be in such a hurry to cut off funding for it!

We begin during the Bush administration, when George W. read a book about the 1918 flu epidemic. He became greatly concerned about the possibility of another killer pandemic, and a preparedness plan was put into place. (This is just one of the many reasons why it's important to have a president who READS !) By the time the Obama administration rolled around, there was a White House unit in place to detect and prevent biological, chemical, and nuclear threats to Americans and assist the states in various medical emergencies. The unit employed nearly two hundred people. The Trump administration had it busted up, so when there was a threat, they were clueless as to how to deal with Covid. Downplaying, then denying the disease's existence seemed to be their main strategy.

So how exactly do you find something that you refuse to look for because you believe it can't be there?

It was left to the states to control the disease. Some of them stepped up to the challenge admirably. Others failed miserably. But through it all, there were heroes quietly toiling behind the scenes.

"It's often individuals who pick up the baton, and they're not even doing it as part of their day job description," said Joe. "Scattered throughout those organizations there are these people, but they aren't organized, trying to compensate for the deficiencies in the system."

Lewis's book celebrates these underpaid and underpraised individuals, doctors and scientists, who had the sense to notice what was happening before their very eyes, and the courage to try to do something about it while our government did not. Let's hope they're all still around when the next pandemic hits.

A disturbing, discouraging, and very necessary read.

One day some historian will look back and say how remarkable it was that these strange folk who called themselves "Americans" ever governed themselves at all given how they went about it.
36 reviews2 followers
May 10, 2021
I started The Premonition but couldn't get past the second chapter. It began like an error-filled screed filled with unlikeable (waaa! no one is listening to me!) protagonists Why go further?

There are MANY reasons to criticize the US response to COVID but, starting in the first chapter, Mr. Lewis takes everything told to him at face value without any critical evaluation. Nothing that the Santa Barbara health officer did was subject to any scrutiny; her negative comments about CDC are just taken at face value. And it seems many of the things that she did could, in fact, have been wrong. Going down the list: what was the reason for the autopsy? They seem to already have the diagnosis and the isolate and they could have just done contact tracing. As an infectious diseases epidemiologist myself, I found it perplexing and, yes, potentially unnecessarily risky. For meningococcus and hepatitis C, county health officers typically go through the state health department, they don't go right to the CDC . These are bread and butter problems. More specifically, there is not just one case of group B meningococcus every four years as Lewis states, there are a few hundred annually in the US.
Tried and true, published protocol, written by the CDC, detail how to manage transmission. That's why there are so few cases. The health officer wanted to try something new (the then unapproved meningococcus B vaccine) but, as the CDC recommended, it should have been done within a clinical trial since the standard of care is already outstanding with little to no transmission As for the hepatitis C episode, that is the life of a health officer. A "nice" outbreak with a good resolution. Yet Lewis uses the episode to harangue the CDC and the State Medical Board. With respect to the mudslide, there is no risk for vibrio cholera in California and it never causes a rash. Either the author or the health officer confused it with Vibrio vulnificus. And although I'm not sure about whether she did the right thing about evacuating the nursing home, the county of 7 deaths makes me suspect that she did not or that there were better ways to have managed the situation.

So who was right here? And who was arrogant? It is notable that the CDC responded each time she called, with multiple people (a weird complaint that there were too many people on the phone). The chief complaint seems to be that they didn't uniformly back her approach. Well, maybe the health officer was actually wrong. How about looking into that, Mr Lewis? Are there not two sides?

Lewis makes it sound like the CA state health officers are dottering retirees. In fact, the health officers in the highly populated counties and many of the others are mid-career and outstanding public health leaders.

In the first two chapters, Mr. Lewis makes the CDC sound like overbearing overlords of public health. That may well be true and it certainly has been stated by others at local and state health departments. Although they have had many triumphs, during COVID, CDC was arrogant, too certain about things that were incorrect, and lumbering in their responses. It appeared bloated, insular and tone-deaf. As I waded into chapter three, I saw a similar, poorly substantiated, yellow-journalistic approach to DHS and HHS. I couldn't go on. How much of the failed response to COVID was politics vs. poor leadership vs. intrinsic flaws in the system is unknown. It would make a great book. Just not this one.
Profile Image for Brian.
316 reviews
March 20, 2022
This is a book about scientists and public health officials who rely on trained intuition. In a system ill-equipped to act nimbly in a pandemic landscape, they are the people that speak to what needs to be done now, not in a month or more when there are more cases and deaths. These characters are the system disrupters of public health in America. You may not agree with all of their conclusions and actions, but this is the best book Lewis has written in years. A fantastic narrative nonfiction that I highly recommend.
Profile Image for Otis Chandler.
386 reviews113k followers
June 4, 2021
Fascinating insider story of how COVID-19 was mishandled by the US government, the CDC, and the WHO. Michael Lewis's tactic that has worked in his past books (Moneyball, The Big Short) worked great with Dr Charity Dean and others - he went deep into the character of this health worker from Santa Barbara, and through her told the story of ineptitude. My only criticism is I think he could have focused more on the global picture, as it was not just every state in the US fighting this thing differently, it was (and is) every country in the world. Maybe that would be good for a sequel...

Hilarious by the way that Charity Dean started in Santa Barbara, and the book describes her visiting the old age home where my grandmother lives!

One of the big things that at this point is lost on many of us, is that in ~Jan 2020, there was a chance to lock down quick on the virus and contain it. And because of the total lack of leadership, that chance was lost. This book describes how the Bush administration (I had thought it was Obama, but nope), had even put into place a plan, which had a lot of research behind it, for how to handle this very thing. But it was dismantled by the Trump and the CDC.

"The greatest trick the CDC ever pulled was convincing the world containment wasn’t possible,” she said. “Our dignity was lost in not even trying to contain it."

We also had no shot at containment because we were not fast to have tests. We could have been had there been leadership prioritizing that, but there wasn't. This was really where we lost the game.

"The absence of federal leadership, combined with the fragmented nature of the American health care system, meant that tests for the virus either weren’t available or were being processed too slowly to be of any use. Joe read stories of people waiting ten days for test results from Labcorp and Quest Diagnostics, two of the country’s biggest private labs."

"The pattern continued right through the pandemic: the Trump administration would claim with fanfare that supplies were on their way to the states and leave it to the career civil servants whose job was to interact with state officials to reap the humiliation when those supplies failed to arrive. It would happen again with ventilators, with the drug Remdesivir, and, finally, with vaccines."

I found this quote very interesting - I wonder how the world will react to this? I would bet many countries will now stockpile and/or build in country manufacturing, though that doesn't seem like it should be the answer. Though in country manufacturing for the vaccine has certainly mattered.

"Here is the frightening aspect of the global supply chain,” said Joe. “When there is a surge in demand, inventory goes to zero. Just-in-time manufacturing. Great concept! Horrible in a pandemic."

The scariest thing perhaps is that all the root causes that contributed to this happening have largely not been addressed.
Profile Image for La Crosse County Library.
550 reviews133 followers
September 13, 2022
Michael Lewis has a real gift for rendering complex problems and systems into manageable bits and pieces for the lay reader looking in from the outside. This was demonstrated amply by Lewis's latest book, The Premonition: A Pandemic Story (2021).

Lewis weaves a story of epidemics and pandemics and the people who fight them. COVID-19 is the latest chapter in a very long history of the ongoing battle between humanity and disease, and disease's agents, the most notorious of them being viruses.

It was both intriguing and disturbing to get an inside look at what went wrong in the early days of the COVID-19 pandemic response--which seemed like everything. Hesitancy by the federal government and the Centers for Disease Control (CDC) to first, call COVID-19 an urgent health crisis, and second, to then take drastic measures to curtail COVID's spread, like social distancing, stay-at-home orders, and increased testing.

The conventional wisdom among CDC experts was that the only thing to do in response was to quarantine the obviously sick and to throw the vast resources at their disposal at vaccine development and subsequent dispensation to the public. This strategy made a problematic assumption that all viral spread is inevitable, so there's nothing to do really except rapidly develop a vaccine, a kind of throwing-one's-hands-up-in-the-air way of dealing with these health emergencies, and one that tried to keep business-as-usual going as much as possible. (Talk about an extremely difficult and potentially dangerous juggling act!)

Also, this neglected the fact that viruses can be spread by asymptomatic people going about their lives, not knowing they are infected and contagious. So for every obviously sick person, there might be many more people out there misattributing their symptoms--if they had any--to something like a common cold. This meant that there was a very incomplete picture of how and where the virus was moving among the population, and likely more spread hidden from view. Ultimately, this fact made more difficult an already very complicated situation at the intersection of politics and science.

Amid the chaotic response of the government, an unlikely band of institutional outcasts came together to fight the pandemic with the resources and personal connections they had. They were dubbed the "Wolverines." (A medical version of the Avengers team-up, if you will.) Unconventional in their thinking, they approached the pandemic in ways that colored outside the lines, while operating within the constraints of ever-changing (yet limited) data and institutional obstacles.

Overall, The Premonition makes for an interesting read and intelligent discussion on the pitfalls of the American healthcare system and how we could potentially do much better the next time there is a health emergency.

Stay safe out there, and don't forget to wash your hands!


See also:

The Fifth Risk: Undoing Democracy (2019) by Michael Lewis--the importance of expertise in governance

The Great Influenza: The Story of the Deadliest Pandemic in History (2005)--a heavily referenced work in The Premonition [Check out our review on this book!]

Find this book and other titles within our catalog.
Profile Image for Carmel Hanes.
Author 1 book127 followers
June 28, 2021
4.5 for an informative and fascinating book.

When Covid-19 hit, and the world began its slow descent into isolation, death, and economic shutdown, I remember thinking how unprecedented this all was, and how unsettling if not downright frightening. I remember thinking that those smarter than me, and with all the power, were going to ride in on their white horses and tell us exactly how they were going to slay this beast. After all, we'd had pandemics before. We'd learned a lot. We had better technology and resources now than back then. We had evolved as a medical community. We had people who knew and cared at the helm.

Not so much.

This book exposes our nation's flawed and siloed underbelly. It smashes many of the myths and common beliefs about how we think (or want) our governmental and private agencies to function. It explains how the individuals who have the knowledge, the ideas, the desire to solve the problem can be buried beneath bureaucracies and political self-interest and self-protection. It shows once again that the "optics" outweigh the deadly realities when it comes to response by those in charge. Except for the brave few.

Some of the surprising takeaways:

--rather than building on old knowledge, research, policies, each administration throws out the old and starts all over again with their own thinking and agendas. Such that, computers with years of data regarding pandemics and pandemic response get removed and the information is gone.
--all the research that's done, and the papers published can lead to a dead end where it doesn't make it to "the last mile" where it's actually put into practice to benefit people, like saving lives. Money/profit appears to be the roadblock in this.
--our medical facilities can't accept free services because their computer systems can't take a zero sum--it gets thrown out as an error. Hence, they had no way to accept free offers for testing and results. Doy...how stupid is that??
--within our private agencies, there are those with a conscience who stepped up and offered free services and those who tried to capitalize on the situation to increase profits. While this doesn't surprise me, it continues to infuriate me, as hundreds of thousands were sick and dying.
--my faith in the CDC just took an enormous hit that it might never recover from. It appears to operate behind the curve and from the standpoint of CYA. Were it not for individual citizens with backbone, we might still be suffering an escalation without end. If ever an agency needed to be autonomous from politics, this is one, and yet it's not.
--our lack of a national strategy was not because none could be had, but because no one had decided to have one, despite available information to develop one.
--one brilliant woman from humble beginnings who refused to be told what to do had an enormous hand in what seems to have worked. This is extra sweet since she came from a town about 15 miles from where I grew up. These kinds of people inspire me and restore my faith in humanity, and I am grateful for their tenacity.

This book is easy to understand, despite a complicated topic. The author gives great examples and analogies for what happens when something like Covid strikes. It answered some of my questions about what took place and why, and what could be done better next time. Because there will be a next time...the only question being, when. Well worth checking out.
Profile Image for Kathy.
211 reviews
May 7, 2021
Just Wow. I think this is the most amazingly honest and frightening non fiction book I've ever read. Filled with amazing people doing so much research and work about pandemics years before Covid 19.

The first thing I did after reading the first 30 pages was to look up who my county health commissioner is. I'm going to research that more. I had only a very small idea how messed up our public health system is but in this book it's spelled out. And the CDC. An entire worthwhile education on how a once independent and revered institution has turned into just another political appointment where bravery is not needed.

So many heroes in this book. Charity Dean, Carter Mecher and many more.

I have no doubt this will be made into a movie. I can also see this as being required reading in classrooms.
Profile Image for Scott Rhee.
1,820 reviews64 followers
October 12, 2022
“The federal government wasn’t just this faceless gray mass of two million people. Nor was it some well-coordinated deep state seeking to subvert the will of the people. It was a collection of experts, among them some real heroes, whom we neglected and abused at our peril. Yet we’d been neglecting and abusing them for more than a generation. That behavior climaxed with the Trump administration. (p. xiii)”—- Michael Lewis, “The Premonition”

“We have it totally under control. It’s one person coming in from China. We have it under control. It’s going to be just fine.”— President Donald Trump, Jan. 22, 2020

“A system was groping toward a solution, but the solution required someone in it to be brave, and the system didn’t reward bravery. It was stuck in an infinite loop of first realizing that it was in need of courage and then remembering that courage didn’t pay. (P. 226)”

Strangely enough, we actually have President George W. Bush to thank for having any precognitive worries about potential pandemics. I never, in my wildest dreams, would have ever even suspected that, but it is, according to Michael Lewis in his new book “The Premonition”, absolutely true.

See, back in 2004, W. read a book. (Another sentence that I never, in my wildest dreams, would have thought I’d ever write.) The book was "The Great Influenza", John Barry’s best-selling nonfiction historical account of the influenza pandemic in 1918, which killed 50 million people worldwide and roughly 675,000 people in the U.S. The book, by all accounts, scared the crap out of W. So much so, that he started asking everyone in his administration—-advisors, scientists, health experts—-what was the official pandemic preparedness plan for the U.S. His equally frightening answer was a simple “There was none.”

So, thanks to W., this country actually—-in 2004—-devised a plan for pandemics. W. had been swayed by something that any virologist, epidemiologist, and medical expert has known for years: a super-killer virus pandemic wasn’t just a theoretical, it was an inevitability. Scientists and doctors weren’t talking “if”, they were talking “when”.

When Barack Obama became president, he got it, too. He bolstered several of the Bush-era initiatives. Science backed it up: a pandemic was going to happen, and it was probably going to happen sooner rather than later.

Then, Donald Trump became president, and in his first 100 days in office, he completely defunded and destroyed nearly every organization, department, and protocol for dealing with and stopping pandemics. He got lucky: he nearly lasted an entire term in which these cutbacks wouldn’t come back to bite him in the ass. It wasn’t until the last year of his first term that it did, finally, come back to bite him. Enter Covid-19.

It’s well-known (by anyone who doesn’t watch FOX News) that Trump did an abysmally piss-poor job of acknowledging the existence of, preparing any kind of pandemic plan to track or contain, or controlling the miasma of misinformation and/or outright lies regarding the coronavirus from a federal level. Trump’s plan was simple: “It doesn’t exist. If it exists, it’ll go away by Easter. If it doesn’t go away by Easter, it’s up to the individual states to deal with it.”

That is, sadly, not an exaggeration. (https://www.businessinsider.com/georg...)

Now, in mid-2021, this country has nearly 600,000 dead citizens due to Covid-19. That’s only about 75,000 less than died in 1918.

And there are still idiots who think that we shouldn’t have shut the schools and businesses down, worn masks, or taken vaccines, which are either government tracking microchip delivery systems or some kind of bioweapon that will turn every vaccinated person into a zombie a year after receiving it. I know too many anti-vaxxers. They are all stupid people. Sadly, you can’t cure stupid.

Thankfully, there are really intelligent people out there working on the problem behind the scenes. None of them give a shit about kudos, back-slaps, thanks, or credit. They just don’t want to see millions of people world-wide die from preventable communicable disease outbreaks.

These are people like Dr. Charity Dean and Carter Mecher. I can almost guarantee you haven’t heard of them. I hadn’t until reading Lewis’s new book. They are true American heroes, but they will probably never receive medals or prizes for their work. The way this world works, they will most likely see lawsuits and idiot anti-vaxxers protesting them. People like them never get the recognition they deserve, because our world likes to ignore and/or destroy anybody who takes risks, thinks outside the box, or bucks the system in any way. Lewis has spent his entire writing career writing about these people.

“The Premonition” is, hands down, the most important book you can read this year.
Profile Image for CoachJim.
157 reviews88 followers
October 28, 2021
Yes, and how many deaths will it take 'til he knows
That too many people have died?

From Blowin’ In The Wind by Bob Dylan

This book is the story of some people who more than ten years prior to 2020 worried about, anticipated, and tried to prepare for the next pandemic. That is in fact the very definition of “Premonition”. It describes their efforts and frustrations to create a plan that would limit the number of deaths in the case of another 1918 type influenza. It tells of the difficulties working with the government bureaucracy and the objections by health officials around the country. After they did develop a comprehensive plan, which stated in part that various social interventions would reduce infections, hospitalizations, and deaths, they presented to a gathering of the nation’s health officials at a conference in Atlanta. There they were confronted with the all too familiar objections about the economic impact of the plan.

An eerie coincidence is the frequent mention of The Great Influenza: The Story of the Deadliest Pandemic in History by John M. Barry. I just recently read that book. It first comes into the story after President George Bush read it in 2006. Afterwards he convened some government experts to find out what the plan was for a similar pandemic. When he found out there was no plan he created a committee inside the White House to come up with one. Here we meet some of the people this book follows. Their study of the 1918 pandemic was that social interventions, if done early, could have huge effects on disease transmission.

There are some unsettling accounts in this book of the CDC, the health care system in the United States, the difficulty we had of getting adequate testing for COVID-19, and the delays in sequencing the genome of the virus which delayed the development of a vaccine.

The CDC is mentioned several times as completely useless in the fight agains COVID-19. The CDC were “constrained by their sense that they already knew everything worth knowing about disease control, and would be threatened by the possibility that in fact they did not.” (Page 94). As one person commented “They really should just change the name. It should be the Centers for Disease Observation and Reporting. That’s what they do well.” (Page 197)

As the CDC and the White House continued to say this was nothing to worry about, they refused to test even people returning to the United States from China. There was no test for COVID-19 even in March of 2020. “By then Zimbabwe could test but California could not, because of the CDC.” (Page 223)

By early April a test was available with results available within an hour, but once they were delivered to public health care facilities it was found that these facilities were so understaffed and under equipped that they had trouble using them.

In order to develop a vaccine the genome information is needed. Yet nearly a year into the pandemic the United States was sequencing fewer of its genomes than any other industrialized country.

the number of genomes being sequenced in the United States was trivial — less than a third of 1 percent of the virus in people who tested positive. (The UK was by then sequencing 10 percent of its positives; Denmark had set a goal of sequencing all of them.) (Page 268)

The sequencing that was being done was because a bunch of nonprofits had begun doing it haphazardly.

In a beautifully symbolic chapter titled “Plastic Flowers” the author recounts how the government and its public institutions failed the American people. The story begins in 1976 with an outbreak of Swine Flu. This flu shared similarities with the 1918 Influenza epidemic. The director of the CDC at the time ordered all Americans to be vaccinated. When a few vaccinated people died from unrelated causes the news media trumpeted this as a result of the vaccinations. This led to a public outcry and the termination of the vaccination order. When the feared epidemic failed to materialize it caused embarrassment to the President and the country. Henceforth directors of the CDC and other public institutions would be political appointees. This meant that these institutions would no longer be led by competent managers, but by people serving at the pleasure of the President. They would be fake.

The book opens with a chapter titled “The Missing Americans”. In this chapter it is noted that the United States “had a bit more than 4 percent of the world’s population,” but had more than 20 percent of the deaths from COVID-19. Had the United States “simply tracked the average of the other six G7 nations” some 60% of the people who died from COVID-19 would have survived. So the greatest nation on earth and the world renowned CDC's management of this health care crisis would go down as a colossal failure. A former director of the CDC is quoted as saying that the CDC was a case study for the world as how to NOT handle the pandemic. (Page 280)
Profile Image for Lorna.
653 reviews352 followers
June 28, 2021
The Premonition: A Pandemic Story is vintage Michael Lewis as he takes us through the years leading up to the pandemic and the people that had the forsight to see what was ahead. Michael Lewis builds upon his last book, The Fifth Risk, in which he highlighted the ignorance of the Trump administration and how unprepared they were to take over the governing of this nation resulting in a deliberate weakening of government agencies and offices designed to protect its citizens. Because, the United States of America had a plan to fight the pandemic with the first draft being written in 2005 as ordered by President George Bush after reading John Barry's The Great Influenza: The Story of the Deadliest Pandemic in History. This office remained viable during the Obama administration, utilizing it for the outbreaks of ebola and the swine flu. However, this was one of the many government agencies to be weakened or dismantled under Trump.

There are many heros emerging from this book, including California public health physician, Dr. Charity Dean, who insisted on tighter restrictions for the state of California than what was being recommended by the CDC. And Dr. Carter Mecher, and his rogue band of physicians known as the Wolverines. What visionaries they all were, indeed! And not to forget the young high school student from Albuquerque, New Mexico and her amazing father, Bob Glass, working at Sandia Laboratories and seeing the value in his 15-year old daughter's science project in epidemiology. And they all were seeing the gravity and the scope of the looming pandemic, even though it was being downplayed and largely ignored by the Trump admininistration.

"Charity Dean had been living for years with a mental model that fit exactly with the facts on the ground. Her model started with two assumptions: One, something was coming. Two, the CDC wouldn't deal with it. The CDC reminded Charity of a person who allows a false but flattering story about himself to circulate."

"Charity had started to follow the events in Wuhan in early January, about the same time Carl Mecher pointed out the virus to his fellow Wolverines."

"By the third week of January, Charity Dean, like Carter Mecher, did not believe that the risk to the American people was low. She thought that the virus was already spreading exponentially inside the United States."

This is a book not to be missed as Michael Lewis leads us through the wilderness and highlights the lives of the unsung heroes. We have all been through a very devastating and heartbreaking time in our global community during the last year and a half as we have fought against the suffering, pain, and isolation caused by the COVID-19 pandemic.
Profile Image for Trudie.
520 reviews555 followers
March 23, 2022

I am quite the fan of Michael Lewis, quoting from my review of his book The Fifth Risk I wrote:

Lewis has a talent for seeking out the unsung heroes in any situation and in so doing navigating his readers around often complex topics - high-frequency trading, baseball statistics, macroeconomics and now the workings of the US federal government.

The Premonition is a natural successor to The Fifth Risk , continuing its themes of the unwieldy nature of bureaucratic monoliths to deal nimbly with a crisis. In this case, the crisis is the Coronavirus pandemic and the Centers for Disease Control ( CDC ) is the black box monolith that fails to react. Now I will caveat this review with the fact I am not American and have no way to verify if Lewis's stance is particularly one-sided or not. I can say the CDC does not emerge from this at all well.

Lewis seems wedded to his schtick of telling a story via his chosen collection of outsiders and misfits, hinting that these characters were selected first and the pandemic story told around them. I think the book suffers for this. I also think he has dumbed down the science or avoided it completely. For example, the use of the term "bugs" and “magical gene machine" are thrown in, presumably to demystify the jargon, but I think it underestimates his readers. If non-financial readers can handle an explanation of synthetic collateralized debt obligations ( The Big Short ) then we can all handle more precise epidemiology, particularly as we are all armchair experts by now.
I suspect Lewis was out of his depth on this topic and seemed more comfortable explaining Charity Dean's approach to public health and the details of the Mann Gulch fire - interesting but not what I was hoping for from this book.

The landmark book about America's response to the current pandemic has yet to be penned, not least because the story doesn't have an ending yet. When it is written I hope to hear from a much wider array of virologists, epidemiologists and government officials than have been tapped here.

Still, this is Michael Lewis and he is nothing if not entertaining even in what I consider one of his lesser works
Profile Image for Dianne.
556 reviews891 followers
December 29, 2021
Fascinating! Explains a lot about the clusterf*** that is the US government’s response (both initial and ongoing) to the COVID pandemic.

Profile Image for Morgan Blackledge.
557 reviews1,912 followers
August 31, 2021
From what I can tell, Michael Lewis (author of The Big Short and Moneyball) has a formula.

His work seems to focus on gritty, odd ball, visionary, outsider types who (a) read the system, and (b) go against the grain, at (c) great personal risk, and ultimately (d) get it right and in so doing, (e) win big.

It’s a really cool ‘rugged ballsy individual’ play by play, view from the ground, meets the ‘smarter than you’ technocrat, complex systems level perspective.

Wait a minute….

Writing this out makes me realize that I’m basically describing what amounts to middle aged managerial class competence porn.

You know?

When the “L7” Cassandra with Asperger’s type middle management every guy/gal is finally recognized/validated/rewarded for “seeing through all the bullshit” while the “fancy pants” politicians and executives fail due to vanity, blind conformity, or cynical “cover your ass” category sins of omission.

I know that’s a lot of scare quotes.

But I’m trying to ironically distance myself from all those “white guy clichés”.

I guess it all cuts a little too close.


The Premonition is the story of Charity Dean, the brassy, sassy and gutsy young female Public Health Officer of Santa Barbra County who got it right about COVID-19 before everyone else, only to be summarily dismissed by the old boy network of doctors, CDC administrators and politicians, and then to be recognized, vindicated and promoted at the 11th hour, to craft what became the national pandemic response policy (once everybody got their heads out of their asses and decided way too late that we needed one of those).

This story hit home for me.

I run a clinic just one county away from Santa Barbara, and similarly to the protagonist, i had to make a lot of very tough decisions related to COVID-19 in the absence of clear information.

The difference between myself and Charity Dean (the protagonist) is that she was (is) particularly knowledgeable and uniquely qualified for the task.

And I was (am) basically learning on the job.

Fortunately for me, Charity Dean made some awesomely good calls, that ultimately ended up influencing policy at the local, state, and federal levels.

And after a really poor start.

We finally have some clarity regarding risk level, policy regarding social distancing, and infrastructure for massive scale testing and vaccinations.

Thanks to Charity Dean, and others like her.

All I really need to do now (unlike a year ago) is follow L.A. County recommendations and I’m basically doing pretty good(ish).

As all of us are painfully aware.

Following recommendations is fucking hard enough.

But at least we’re not flying blind anymore.

So yeah…

One of the cool things I was exposed to in this book, is the nerdy fun side of risk management, and the basic insight that the lion’s share of good governance is to model and mitigate risk.



I have been enjoying these revenge of the nerds style lessons in very recent history books lately.

Particularly considering how crazy, confusing, stressful and tragic our recent history was (is).

It may just be one big psychological defense to search hindsight for ways we could have avoided some or (better) all of that awful nonsense.

But on the off chance that knowing history really can reduce the likelihood of repeating it.

I think it’s worth investing a couple kilowatts worth of action potentials, to sift through the wreckage of the recent past, to find a little clarity and maybe even a snowball’s chance in hell that we can avoid the next one of these (assuming we survive this one).

Important read.

5 stars ⭐️
Profile Image for Emma.
203 reviews117 followers
May 8, 2021
I was sure I would never want to read a book about this pandemic. But I was wrong! This is mostly about the nerds and outsiders who saw it coming and sounded the alarm, and how the system failed. Could have read 500 more pages of this.
Profile Image for Tim.
149 reviews6 followers
May 10, 2021
This book was a page-turner, but also about 200 pages shorter than it needed to be.

This book has three characters: the science, the government organizations, and the heroes. Come for the heroes, stay for the science, and remember the government organizations. Lewis has found some excellent characters to tell the story of the science and the bureaucracy through, and it's fascinating to hear how the now-famous book about the 1918 flu inspired George W Bush to invest in pandemic preparedness.

More than half of the book happens prior to 2018, and the remainder mostly focuses on January 1, 2020 to March 19, 2020 (when California became the first state to declare a lockdown). The rest of the pandemic was kind of glossed over. Maybe this is just because the book was written from the point of view of Charity Dean, who left government in April 2020. I appreciate that containment would have been better than what we did, and clearly containment was possible in some countries. But clearly that's not the only thing the US did wrong. Most American who died of corornavirus died after the events of the book. What could we learn about our policymaking mistakes during that period?

If you're looking for a full postmortem of the United States's pandemic response, you're going to need to wait for another book (which I'm sure another author is writing at this very moment). And that book just won't be as fun to read as this one. But it does still need to be written.

Some reviewers have noted that this is told in a pretty one-sided way, and that's definitely true. The book might feel a bit more accurate if it hued more to the ideas and less to the heroes, who I'm sure are more flawed and less prescient than Lewis says. But it might not be as much of a page-turner. And, regardless, the message of the book is still valid: the US government is ineffective because power is decentralized and political rather than technocratic. He tries to hit an optimistic note at the end - "maybe somehow for-profit companies can do the job!" - but I think a note of pessimism would have been more honest.
Profile Image for Skip.
3,249 reviews393 followers
July 12, 2021
Michael Lewis has written a narrative of the COVID-19 pandemic, starting with an excoriation of President Trump's disastrous handling by downplaying the severity of the disease and muzzling anyone who broke ranks with his agenda. Lewis highlights the actions of a County public health official in California (Dr. Charity Deans), a hodge podge group of like-minded folks in Washington and a professor in California (who developed a reliable COVID test), who refused to be misled by the terrible advice and inaction by the Center for Disease Control (CDC) in Atlanta. Strangely, Dr. Fauci is barely mentioned in the novel, and it got very repetitive towards the end.

My favorite quote: If some other dumb fuck can do it, so can you.
Profile Image for Andy.
1,351 reviews462 followers
June 23, 2022
The characters here seem as baffled by the incompetence of the US government as the rest of us, and we don't get into the depths of pandemics enough to make sense of it all beyond that. The conclusion seems to be that we should declare red alerts frequently because there's just no way to prevent pandemics or to figure out in time what is merely a false alarm. This unsatisfying ending is based on Lewis's interpretation of the 1976 flu vaccine fiasco.

Lewis acknowledges that the 1976 vaccine campaign did kill people and had no benefit. The first rule of medicine is Do No Harm, so I have to look at this as a cautionary tale as opposed to an unheralded success. Lewis however goes along with the CDC's interpretation that the panic over flu in 1976 was an overreaction only in retrospect. To do this, he needs to skip over all the evidence that went against the CDC's decision at the time, beginning with the story of the death of Private Lewis that was the alarm bell for the whole crisis, and going on to the heroes of vaccination/public health who were against the plan. ( The Swine Flu Affair: Decision-Making on a Slippery Disease --- The Coming Plague: Newly Emerging Diseases in a World Out of Balance.) This is a big problem, because ultimately his explanation for the much bigger COVID-19 fiasco today is that the CDC used to do things right until stupid politicians punished them for doing the right thing in 1976 with swine flu. Also, it's not as if the CDC hadn't been political before 1976: Inside the Outbreaks: The Elite Medical Detectives of the Epidemic Intelligence Service.

Michael Lewis is a genius of non-fiction writing but this is not his best stuff. He doesn't seem to understand epidemiology the way he does finance or sports, so this doesn't have the feel of his previous books where he's masterfully explaining some complex concept through interesting characters.

-Nerd addendum:
For the 1918 flu, his heroes make a big deal about the difference between St. Louis and Philly in terms of social distancing measures, but don't get into the fundamental differences before that related to the concentration of WWI shipyards and airplane factories in Philly and how that might have influenced the severity of the disease in Philly. The "Wolverines" starring in the book and their one paper on 1918 are very interesting and worthy of attention, but that is not the whole story of the 1918 flu.
Profile Image for Morgan .
795 reviews131 followers
November 16, 2021
**Note: An entire sentence was left off paragraph #2 in my original – I have now corrected it.**

It appears that Pres. George W. Bush in 2005, in a panic after reading a book by John Barry “The Great Influenza: The Story of the Deadliest Pandemic in History” had the foresight to take action should something like that ever happen again and an organization was formed. Bush was (rightly) trying to prepare for the future. Actually, a rather astute move on his part.

Moving on: This book chronicles some very clever (perhaps unorthodox) people who took it upon themselves to attempt to produce a system that might work should a pandemic like the Spanish flu of 1918 ever happen again. Because, in their wisdom, it was not a matter of if, but when. Who knew it would actually happen in 2019?**At which point no one in authority or power was the least bit interested. Including the CDC!**

It is written in plain English for any lay person to follow – no medical or scientific knowledge required. It grabbed me from page one in the same way a suspense/thriller would do.

While it deals primarily with the USA – it should be taken as a warning to any and all other countries.

It is as frightening as it is enlightening and chock full of the names of some very brave heroes who should be house hold names today.

The bottom line is: Red tape, bureaucracy, politicians, money grabbers and people with no imagination or common sense are killing us.

If you think the Covid-19 pandemic is the last pandemic you will ever see you would be wrong. So best be prepared. Better read this book.

Brilliantly done Mr. Lewis!
Profile Image for CJ Sinclair.
16 reviews10 followers
October 6, 2021
This was such a frustrating read. Made me want to smack so many people.
Profile Image for Bonnie E..
160 reviews23 followers
May 31, 2021
Truly amazing book by an author whose writing style is very accessible. I read Lewis's last book, The Fifth Risk, about a year and half ago. It was quite an eye opener especially if you believe that a basic tenet of government is to keep us safe. That book unveiled the extent to which deep expertise and experience in things that really matter had been undone, particularly by the Trump administration. The Premonition takes that book to the next level as it unveils just how badly the pandemic was bungled, with much criticism leveled at the CDC and failure of the imagination at the highest levels of government.

Lewis manages to find the unsung heroes in complex situations, and the public health response to a pandemic is one of the most complex imaginable. The book follows medical renegades who warned for years that something like the Covid-19 pandemic would likely occur, and who independently concluded the importance of early targeted and layered interventions. Some of them had worked on a pandemic response before Covid 19 reared its ugly head.

In 2005, George W. Bush read a book, The Great Influenza, about the 1918 flu pandemic and asked those around him what the country's strategy was for the next one. He learned that it was simply to stockpile antiviral drugs and speed up the production of vaccines. He called it bullshit and said we needed a pandemic plan for the whole of society: travel, commerce, health, borders. He asked Congress for $7.1B in to spend on funding for a strategy after calling in a team of experts to create one.

Carter Mecher is one of the most compelling characters in the book, chief medical officer for the VA in Atlanta. He was the antithesis of a bureaucrat, as he possessed a strategic and creative approach to thinking and problem solving. He was asked to work on the pandemic plan requested by the Bush White House. He partnered with Richard Hatchett, a southern poet who became a doctor. When called to help, he was running a program at the National Institutes of Health. A Pulitzer Prize-winning poet asked him once why he had gone to medical school, to which he responded: "Writing is too hard." We also get to meet Lisa Koonin, a lower level functionary head at the CCC who was tasked with commenting on the plan and whose initial responses were all in the negative. She describes herself: "I was kind of a typical CCC person. Everything was no, no, no. Everything had to be right. And it had to be so right that it was not wrong." She was the team's first real connection to someone within the CDC who helped steer them through so much of that organization's ultra-cautious red tape, and who wound up authoring some of the plan. Charity Dean is another hero in the book. She was chief public health officer for Santa Barbara County, California. She grew up poor but made her way to medical school, even after her church commanded her to quit Tulane University and return to Junction City because her grades were too high and she was not minding her husband. Instead she became a doctor. She challenged conventional wisdom throughout her life which ultimately led her to work with the likes of Melcher and Hatchett after Covid 19 hit. Her experiences as someone in the trenches with responsibility for the health of an entire county (and subsequently the State of California) was invaluable.

Much of the book concerns itself with these individuals as well as several others, all of whom were brilliant in their own right, and each of whom deeply cared about getting in front of a public health cyclone like the novel coronavirus in order to save lives. The $7.1B plan that had been published years prior was not rolled into action, as there was little to no funding made available to do so, and politics, people and processes all got in the way. The CDC was one of the most disappointing entities of all in its response, with an apparent lack of leadership or sense or urgency.

Interwoven into the story is one that Richard Hatchett told about the Mann Gulch fire, which took the lives of twelve of the fifteen young elite smokejumpers who parachuted in to contain it. Two were badly burned but survived and only one of the fifteen was unscathed. He had the presence of mind to create an escape fire, a strategy which no one had ever heard of before. Carter Mecher took lessons away from the Montana calamity, likening it to the difficulty people had imagining exponential growth, even when their lives depended on it. When this team of doctors and epidemiologists began to understand the insidious nature and speed at which the virus was spreading, they became even more focused on trying to get critical things in place, like testing and genome sequencing. We all witnessed how that played out over time. Once it became clear that the federal government was not going to provide resources, states, cities and counties were all forced into a free-for-all to scramble for supplies and were being sent things like Q-tips instead of nasal swabs.

This is a masterful account of the early stages of the Covid 19 pandemic, told through the lens of some of the more interesting people you'd ever want to know.
Profile Image for Kerry.
788 reviews92 followers
August 19, 2021
I picked up this book as I wanted to understand what happened in the early days of the pandemic and to see what could be learned.
There is much in this book to recommend. The audio was excellent and the information easy to follow and understand. Michael Lewis uses a formula of finding key players and doing a deep dive into how their foresight and actions color between the lines of what we might have read or seen in the media. There are a number of names, most of which I had not heard previously. People behind the scenes.

Lewis choses to stay away from a heavy political analysis which I found very refreshing. There is minimal Trump bashing and only a passing reference to Fauci. Most of the first chapters tell of earlier pandemic planning during the Bush presidency and the lack of considered planning following that initial governmental interest.
I kept thinking of a saying, “that all men look like good sailors in calm seas”. Covid was our storm and we did not fare well. There were many assumptions that even the people involved believed that were just not so. For example: How the C.D.C works and might function in a crisis, what we might have learned from the 1918 pandemic and what tools are available that could have helped to protect populations.

This is a book about the human aspect only in the broadest terms. It is mostly about government and the institutions we thought we might rely on to protect us in a health crisis and how neglect and interference has weakened them. It is a book that is about key people who saw a problem developing and what they thought should have been done and were not listened to and the problems that resulted that affected all of us. The question remains as to whether this virus could have been stopped had different initial actions been taken. At what point did we really understand the threat? How many lives might have been saved?
These are big questions that I am not sure we will ever have answers for. Lewis does a great job of exploring what was done and not done. I came away feeling that this is only part of the story. I am sure there will be many more books that cover this topic but this one is a great place to start if you have an interest.
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1,346 reviews67 followers
May 9, 2021
Here's the explanation why I gave a book that might otherwise be four stars an extra star:

We can't write the definitive book about this pandemic yet. As Lewis describes, multiple times, in this pastiche of stories, we're looking at puzzle pieces, and many of those pieces don't fit together. There are stories about the social networks that spread viruses, and novel, effective approaches to epidemiology that were never considered. There are tales about the deadly mix of politics and public health. They're all fascinating--and none of them tells the complete story. We'll still in this thing; it's still scary and devastating.

But this book--exactly like The Fifth Risk--wades into the middle of the crisis, and begins sharing stories about the huge mistakes made early on, things that could easily have been prevented. He goes back as far as the 1976 Swine flu scare, and how it led Ronald Reagan to decide the head of the CDC had to be politically appointed, rather than chosen by peers, for just one example. And Lewis makes the salient point, at the end, that the next pandemic may actually be worse--so what we have learned from mishandling this one ought to result in some significant changes. It most certainly didn't have to be this way.

I'd like to think that Americans--most Americans--understand that. But maybe not. We've been told so often how exceptional we are that some people believe it. The book is full of tidbits like that.

But as a coherent case study? Not so much. We're not ready for that. But the look behind the curtain at all the things experts knew going in, and learned on the fly, was fascinating.
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