Spiked population density of people and livestock. Policy capture by agribusiness. Underfunded and poorly managed public health infrastructure. Opacity and the undue shifting of blame onto smallholders. The inevitable clash between a public need for system change and privately-benefitting ideologues (tempering projections on climate and pandemics in order to be 'taken seriously' by unserious demagogues). Mike Davis brings all of these puzzle pieces together in this political epidemiological account of an earlier pandemic (H5N1) portending ill-preparedness for another (SARS-COV-2). Davis does an excellent job of simplifying the science without being simplistic---that is to say, you won't need a virology background to follow the science, which is boiled down as much to the political as the genetic factors for its spread. There's just enough of the science to highlight the mismatch between health officials' dire warnings and the political inconvenience for agribusiness and their paid-for politicians (and also between those warnings and states' willingness to support transparency or effective localized containment).
As with his others works such as Late Victorian Holocausts, or City of Quartz, Davis is truly a master of explaining the lateral connections and shining lights into the backrooms that manifest disasters in development. As against conspiracy thinking, his narrative does not deny unaccountable and opaque class power (in outright lies to international agencies for 'national economic interest', choices not to publicize local outbreaks, etc.) but makes it material, corporeal.
Davis boils down "influenza ecology" several multi-scale factors:
1. The "Livestock Revolution" of factory farming/agribusiness.
2. The industrial revolution in South China as a commercial nexus.
3. Emergence of third-worl "supercities" and their slums.
4. "the absence of an international public-health system corresponding to the scale and impact of economic globalization."
Choice Excerpts:
"multinational capital has been the driver of disease evolution through the burning or logging out of tropical forests, the proliferation of factory farming, the explosive growth of slums and concomitantly of “informal employment,” and the failure of the pharmaceutical industry to find profit in mass producing lifeline antivirals, new-generation antibiotics, and universal vaccines....Permanent bio-protection against new plagues, accordingly, would require more than vaccines. It would need the suppression of these “structures of disease emergence” through revolutionary reforms in agriculture and urban living that no large capitalist or state-capitalist country would ever willingly undertake."
"Today’s “landscape of disaster” is eerily similar to 1665 and 1918: urban populations locked inside their apartments, the flight of rich to their country homes, the cancelation of public events and schools, desperate trips to the markets that often end with infection; society’s reliance upon hero nurses, the lack of beds in hospitals and pest-houses, the mad search for masks, and the widespread suspicion that alien powers are at work (Jews, a passing comet, German saboteurs, the Chinese). But this time around there was little mystery about the identity of the microbe—SARS-CoV-2 was sequenced almost overnight in January—or the steps necessary to fight it."
The management of the epidemic in Hong Kong and Toronto:
"...published in 2004 by the Journal of the American Medical Association (JAMA). As the panel chairs emphasize: “Both areas were hampered by underinvestment in public health infrastructure, diminution of public-health leadership, and weak links between health care and public health.” In both cities, moreover, the health systems were overwhelmed by the epidemic. No one had expected a disease that targeted hospitals or took such a heavy toll on primary health-care personnel... The Ontario government had to import, more or less clandestinely, several hundred U.S. doctors to make up the shortfall caused by ill or frightened physicians. In Hong Kong the hospital system almost broke down because of the lack of infection control in emergency rooms and the shortage of isolation units (single, negative-pressure rooms). ...“neither jurisdiction had enough infection control practitioners and infectious disease specialists.” The distressing spread of SARS among medical personnel, however, was not due to the virus’s super-infectivity, but, rather, to surprisingly widespread failure of hospital staff to adhere to proper protective clothing and standard hygiene (such as simple hand-washing). In both cities, lines of authority were blurred or contradictory, and general practitioners were often left totally in the dark about diagnostic and therapeutic procedures. In the end, the nineteenth century, not the twenty-first, defeated SARS: “containment of SARS relied heavily on application of public health and clinical infection-control measures rooted in nineteenth-century science.”
H5 pandemic:
"there was broad agreement among researchers [in the late fall of 2004] that an H5 pandemic was not simply imminent, it was 'late.' Getting this urgent message across...was the urgent task entrusted to the WHO...It was an uneven and divided effort compromised by undue deference to the interests of powerful states, including China and the United States, which generated some lurid headlines and rhetorical promises but none of the truly decisive action urged by experts on the ground."
"Under Democrats, as well as Republicans, Washington has looked the other way as local health departments have lost funding and crucial hospital surge capacity has been eroded in the wake of the HMO revolution. (A sobering 2004 Government Accounting Office [GAO] report confirmed the 'no state is fully prepared to respond to a major public-health threat.') The federal government also has refused to address the growing lack of new vaccines an antibiotics caused by the pharmaceutical industry's withdrawal from sectors judged to be insufficiently profitable; moreover, revolutionary breakthroughs in vaccine design and manufacturing technology have languished due to lack of sponsorship by either the government or the drug industry."