The Coming Plague: Newly Emerging Diseases in a World Out of Balance

Because, I mean, who doesn't read a book about the plagues that might come when you're stuck at home because of the one that's already here??

Laurie Garrett's The Coming Plague is a good book, but a dated one (publication date: 1994). Having read David Quammen's Spillover a few years ago, I also found much of the information repetitive. They're certainly not the same though - for example, Garrett's treatment of the origins of HIV/AIDS is stronger than Quammen's, though she also tends to get bogged down in the weeds more easily. Similar to Quammen, Garrett explores the origins of numerous plagues, primarily those of zoonotic origin: the actual (bubonic) plague, Hendra, Ebola, hantaviruses, Machupo, Lassa fever...all the wonderful ways one can die. (Really. I'm typing this in the midst of Covid-19, grateful beyond reason that we're "only" facing a what we are, and not, say, a hemorrhagic fever.)

That said, there's no question that if I had to choose a single word to describe The Coming Plague, that word would be 'depressing.' For example, as we contemplate the potential of social distancing until there's a vaccine for covid, we're regularly reassured this will happen in the next year or two. Garrett writes, though, that on April 23, 1984, HHS Secretary Margaret Heckler announced the discovery of HIV. She also forecast an AIDS vaccine would be available within 5 years. The 36th anniversary of said pronouncement will occur next week.

Garrett also noted, way back in 1994, that virtually no civilian hospitals in the United States were equipped to handle a highly contagious, lethal microbe. Glad to see not much has changed in the past 25 years. Likewise, in contemplating future pandemics, experts expressed to Garrett their uncertainties around who should be in charge in the event of such an outbreak, and who knows enough to make "these kinds of decisions." Indeed.

Garrett's writing is at its finest when she recounts the histories of those infected with or researching (or both, simultaneously) Machupo, Ebola, and the like. In between their stories, the narrative can become bogged down in scientific detail, much of which I admittedly skimmed. (Again - this book was written in 1994. The plague has come. And the book is 772 pages long. It's just not reasonable to think of reading every word closely.)

Four stars.