When atheists mock the faithful, they often point to biblical contradictions such as the conflicting Genesis stories. If Adam and Eve were indeed the first couple, who lived in the Land of Nod? Or, as Henry Drummond says of Cain’s wife in Inherit the Wind, “now where the hell did she come from?”
In The Premonition, Michael Lewis’s new book, the “she” is Charity Dean, of California. As the book begins, Dean is the assistant director of the California Department of Public Health, and she is here to shake our faith in America’s pandemic response. It’s the word “assistant” that matters. Dean is not in charge of anything. But she is one of those preternatural doers whose stories Lewis loves to tell in his wildly popular books (among them Moneyball, The Big Short, and The Blind Side).
Dean, along with Carter Mecher of the Veterans Administration, is the leading figure in what Lewis calls a “rogue group of patriots who were working behind the scenes to save the country.” Save America, that is, from its own government’s mismanagement of the COVID-19 pandemic. While Donald Trump’s COVID Task Force is giving its daily briefings, Dean and Mecher are toiling in the Land of Nod. Dean takes to Mecher immediately because “he wasn’t some slick White House dude. He was like a guy in a t-shirt with motor oil under his fingernails.” The very language Lewis uses to punch up his heroes is shot through with anti-establishmentarianism. His rogue group of patriots practices “Redneck Epidemiology,” and they call themselves “Wolverines” in reference to the rebellious teenagers in the movie Red Dawn.
But they’re not really rogues, in truth. This informal network, held together by emails and Zoom calls, grew quickly to include members of the Department of Homeland Security, Trump’s COVID Task Force, even Anthony Fauci. Lewis celebrates their outsider status but also describes a good-faith elite meritocracy that allows their voices to carry through. In what other country could an “assistant director” circumvent her direct superior (the incompetent Sonia Angell, who had been given the top job as a reward for her work on “righting racial injustice in health care”) and report directly to her state’s governor?
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THE PREMONITION is a thrilling and sobering account, but it doesn’t necessarily tell the story Lewis thinks he’s telling. By the time the COVID Task Force had been established on January 29, 2020, Dean and Mecher had concluded the worst. Extreme measures, including lockdowns, would be vital to stopping a virus that was already spreading out of control. There was a lag of six to seven weeks between when we “should have known” and when we finally acted that was agonizing to those who were trying to sound the alarm. If the Wolverines had been in charge, lives would have been saved.
For Lewis, our failure is a simple matter of “the record.” He writes that “the United States, with a bit more than 4 percent of the world’s population, had a bit more than 20% of its COVID-19 deaths.” But before we accept this narrative, already so entrenched as to be taken for granted, it seems fair to pause here and ask: Are we certain that the response was a failure? After all, the United States is the most obese country on Earth (other than a handful of tiny island nations). We outpace countries of comparable economic size in most comorbidities, such as heart disease, respiratory disease, and diabetes.1 We are, in fact, among the world’s most welcoming COVID hosts. And yet our death rate from COVID (1.8 percent) compares more than favorably with Germany’s and the United Kingdom’s (2.4 percent) and is comparable to France’s (1.9 percent). Given our unhealthy population, is it possible that we punched above our weight?
This question matters little to Lewis, or to the families of the 620,000 Americans who have died of COVID. They have a right to ask what could have been done better, and Lewis has an answer. “Better,” for the most part, would have meant “faster.” The Premonition walks us through the terrifying math of exponential infection. With a long incubation period, during which carriers shed infectious virus, every day matters. But even in this regard, it must be said that the United States was no laggard. Our state lockdowns were imposed at roughly the same time as other nations’, and our travel restrictions were imposed sooner than most.
Nor had the threat of a coming pandemic been ignored in the United States. In fact, the necessity of lockdowns and social distancing had been proposed earlier in a response plan initiated by then-President George W. Bush. He had just read The Great Influenza, John Barry’s history of the pandemic of 1918, and was spurred to action. “We need a whole society plan,” Bush said, after rejecting an existing plan centering on vaccines. “What are you going to do about foreign borders? And travel? And commerce? And how were you going to stop hundreds of thousands of Americans from dying while they waited for even a speeded-up vaccine?”
A plan was drafted—and then promptly forgotten with the transition to the Obama administration. Carter Mecher had been one of the officials tasked with helping to sell the pandemic strategy, but it “had been swept away.” The threat of institutional amnesia is one of the implicit themes of The Premonition—which, taken as a whole, is a powerful brief against a centralized pandemic response. Lewis’s account is a catalogue of the perils of consolidating the pandemic response into too few hands. This theme, however, is one that seems to make Lewis oddly uncomfortable.
The White House itself is mostly off stage. Donald Trump appears only occasionally and is faulted for doing harm to the national mobilization. Even so, Trump is not the villain of The Premonition. No, the Centers for Disease Control is the main target of Lewis’s ire.
As portrayed here, the CDC is guilty of every clichéd rendering of bureaucratic ineptitude, careerism, and risk aversion. From her first encounter with the CDC, while tracing a hepatitis-C infection in Santa Barbara, Dean is appalled. Is the CDC a research facility or our primary agent of containment, as its name implies? According to Dean, “the CDC did many things. It published learned papers on health crises, after the fact. It managed, very carefully, public perception of itself. But when the shooting started, it leapt into the nearest hole, while others took fire.”
When COVID-19 strikes, the CDC fails at its first and most important task: testing. Given the long, symptomless incubation period of COVID-19, the availability and prioritization of testing was paramount to stopping the spread. But when 57 Americans were repatriated from Wuhan in the winter of 2020 and quarantined in Omaha, the CDC not only didn’t test them, it forbade the Global Center for Health Security from conducting its own tests. The CDC also refused to use the word “pandemic,” protected its monopoly of test kits, and withheld data.
The most vicious indictment of the CDC comes from one of its former directors, Bill Foege. In a letter to Robert Redfield, the director under Trump, Foege wrote:
You and I both know that…despite the White House spin attempts, this will go down as a colossal failure of the public health system in 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.
Lewis provides plenty of evidence to support this criticism of the CDC, but none to support his claim that “it had allowed itself to be used by the Trump administration.” The invocation of Trump here is gratuitous and relies on a presumption that the former president simply had to have been the root of all problems. But if that is true, why does The Premonition read like a partial vindication of Trump’s instincts, beginning with his distrust of the CDC? Lewis does not delve into the origins of the virus or the World Health Organization’s cozy relationship with the Chinese Communist Party, but time has been increasingly kind to the former president on these matters.
Trump, according to Lewis, “had said that it was every state for itself.” This was not true as a matter of administration policy (ventilators were incepted by the federal government on a massive scale and sent to the states). But it would not have been entirely wrong if it were. Lewis quotes Dean approvingly when she proposes “radical accountability. Government has a role, but its role is to empower the grass roots by giving them data.” In the final analysis, we needed a balance between state and federal roles. Are we not grateful today that Texas was able to end its lockdown before California? That Florida opened its beaches?
Trump is unique among our presidents in his ability to discredit himself. That was never more apparent than during his daily COVID briefings. Still, as awful as his vaudevillian conduct was, even here the criticism went too far. Following his own bout with the virus, Trump was mocked for saying, “Don’t be afraid of COVID. Don’t let it dominate your life.” But was this any more out of touch than FDR’s insistence that we had “nothing to fear but fear itself”? Roosevelt spoke those words in 1933, a year in which unemployment peaked at over 25 percent, and half a million Americans were fleeing the Dust Bowl. American presidents used to be allowed to preach a little optimism without having the world come down on them.
The Premonition is a story about the dangers of authority concentrated in the wrong hands, and about a unique American culture that fosters constructive rebelliousness. What we learn from Michael Lewis, as we often have before, is that America produces and attracts heroic citizens—and after some missteps, it even listens to them.
1 Peterson Kaiser Family Foundation Health Tracker
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