Recommendation: It’s fine…

Where to read: It makes people uncomfortable on public transport

Read with: Shah claims that a 20% gin solution can be quite efficacious in killing cholera vibrio…

In brief: John Snow did know something, as it turns out. 

This should have been a history of cholera, not a book about pandemics more broadly – the story-telling about the former is brilliant, the analysis on the latter is a little slipshod.

Cholera broke out in disastrous fashion in the 1800s in India and then moved into Europe, devastating the major cities (Paris and London among them) and spreading to the Americas. There, it smashed through Manhattan, taking advantage of the appalling conditions in the tenements and the lack of sanitation – once cholera got into the wells and the groundwater in New York (or the Thames in London), the city was fuuuuucked. International travel, high population density, contaminated drinking water, ineffective public response and the parlous state of medical science contributed to hefty death tolls and repeated outbreaks. Cholera is, or so Shah argues, the blueprint for future pandemic diseases.

The problem with this conclusion is that she focuses on cholera but doesn’t really illustrate her point with anything else. She dashes around touching on Ebola, SARS and a couple of influenzas (bird and swine, obvs) but it’s not really that useful in comparison with The Coming Plague or even a cursory google overview on recent disease outbreaks.

The final chapter is a whirlwind tour overview of theories about the historical interactions between humans and diseases, suggesting that exposure to epidemic and endemic diseases have played a key role in human evolution. It’s a fascinating area I’d be keen for more information on, but it reads like Shah summarised key studies on post-it notes and then whacked them into the book.

Laurie Garrett, author of The Coming Plague, reviewed Pandemic for The New York Times and I would highly recommend looking over her review before adding it to the bookshelf.

I don’t quite agree with all of Garrett’s critiques here (I didn’t get the impression Shah advocates for solutions so much as deals with some of the current possibilities) however the overarching criticism is probably fair. 

PS. For Hamilton fans, Aaron Burr gets a mention here – I’m afraid you get another reason to loathe the man

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