Review of Mark Honigsbaum (2020). The Pandemic Century: A History of Global Contagion from the Spanish Flu to Covid-19 Cambridge, MA: Penguin. 321 pp.

1.    Introduction

The last few months have been unprecedented. The massive human and economic toll of the Covid-19 pandemic has taken governments and policymakers across the world by surprise. Economies have ground to a halt, public health systems have crumbled and millions of lives have been lost. The sheer shock that the virus has dealt with the global economic system has led to a sea change in the policy arena (Saravelos 2020; Macron 2020). Where just a few years ago markets ruled the roost, today even the most vocal free-market advocates have turned into champions of state interventionism; and where earlier health was rarely if ever given extensive importance, today it has become the focal point of development strategies. But even as the world has been shaken into accepting these facts, there remains within policymaking circles, a certain reluctance to address the deep-rooted structural causes of the epidemic, the historically shaped weaknesses of governance structures that have been put into place over the last few decades, and the fundamental flaws of development strategies that have focussed primarily on economic growth to the detriment of human development (Baldwin and Di Mauro 2020). Policy retaliation to COVID - 19 served to widen and intensify the pre-existing class, caste, and gender inequalities in society. The evidence is present in the prevention measures that were instituted upon the population: the measures could be implemented in the living conditions of the middle classes and elites, but not among the urban poor and rural dwellers (Jayati Ghosh 2020). In fact, despite all the changes that the pandemic has brought about, there remains a widespread impression that the pandemic in some senses was unexpected and largely the result of a series of unfortunate, contingent events all of which blew so out of proportion that it engulfed the entire world. In short, the discourse on the covid-19 pandemic continues to be haunted by the assumption that it was somehow exceptional and somehow external to our model of social life, governance structures, and patterns of wealth accumulation.

2.    Pandemics and Public Health Response

In this context, Mark Honigsbaum's book, "The Pandemic Century: A History of Global Contagion from the Spanish Flu to Covid-19" is a welcome intervention that challenges the externalization of pandemics and instead shows how pandemics are outgrowths out of social, economic processes and are thus intricately connected to institutional scaffolds and patterns of growth. It is a welcome addition to what has become emerging literature on the history of pandemics such as Epidemics and Society: From the Black Death to the Present (Snowden 2019) and Viruses: A Very Short Introduction (Crawford 2011).

The book that takes the reader down an expansive memory lane as it details the most notable pandemic occurrences of the past century. The book follows a parallel structure wherein each chapter has its beginning, middle, and end that ties up together at the conclusion. There are 10 chapters, along with a prologue and epilogue. The book contains extensive information at the end about the sources from where he cites his information and a page about all the abbreviations mentioned in the book. Using deeply researched material and engaging narration, Honigsbaum's The Pandemic Century seeks to educate the reader about the catalysts of the past epidemic outbreaks and how they were dealt with economically, socially, and politically. Additionally, it addresses the outbreak of COVID-19, the virus that has claimed the lives of around 3 million people as of April 2021.

Honigsbaum skilfully narrates the accounts of 10 different outbreaks, some of which include Influenza, Pneumonia, Ebola, Zika, etc. The focal theme encompasses the idea that different kinds of changes and developments in our ecologies trigger unknown pathogens and these act as a driving force of a pandemic. He also details media responses in addressing these issues and the government’s procedure in dealing with these complex problems. He begins by highlighting the main causes, symptoms, and repercussions caused by the disease. In some cases, unsanitary surroundings proved to be the chief cause for disease manifestation. For example, is the outbreak of Legionnaire’s disease that was caused mainly by ill-maintained water storage and plumbing systems. Another example includes the period during 1918 when influenza broke out in the US; soldiers possessing varied immunological profiles were forced to live in proximity of each other at the camps, which made the disease spread like a wildfire in a dry forest.  Over 4.7 million lives were lost by November 1918. Along with the varied immunological profiles, the soldiers’ transfer to France and them mixing freely explained the high virulence of the virus and the atypical age profiles of the victims. By November 1918, it was becoming a familiar seasonal ailment. Now when we jump to the case of AIDS, whose first case was discovered in December 1980. HIV, the virus that causes AIDS is a retrovirus- Retroviruses utilise a unique enzyme to translate its genetic information into DNA, which can then integrate into the host cell’s DNA to multiply itself. Low maintenance of sexual health resulted in the loss of T-cells which specialize in providing immunity to your body system. Today, 1.1 million people living with HIV, and over 700,000 people afflicted with AIDS have passed away. Apart from unhygienic environments, a significant reason for the spread of these outbreaks were the factors of negligence and ignorance on the part of health officials. Back during the reign of influenza, more pressing warfare issues had come up which had led to officers taking a more complacent view upon the matter. As Honigsbaum puts it, "It is also because of the tendency of medical researchers to become prisoners of particular paradigms and theories of disease causation, blinding them to the threats posed by pathogens both known and unknown” (Honigsbaum 2020: Prologue xiii).

3.    Final Remarks

Honigsbaum is clear that strong governance mechanisms and safety precautions alone cannot in themselves avert future pandemics altogether. However, cohesive governance and public health response mechanisms can certainly minimize the worst effects. For instance, when the SARS (Severe Acute Respiratory Syndrome) infections were skyrocketing in China (there were 339 cases in Beijing alone), the authorities managed to mobilize resources on a large scale to curb the spread. Mass quarantines and new treatment facilities were almost instantly instituted, and disaster was prevented. Scientists have made monumental progress in understanding the epidemiology, pathophysiology, and virulence of the different pathogens. This is precisely a lesson that needs to be taken forward as well. Honigsbaum makes a vital point about the issue we are facing now – COVID. The outbreak of COVID has resulted in the loss of thousands of lives, but he notes that policymakers have had plenty of warnings in the past that a pandemic of this intensity was heading our way. However, our collective negligence, supported by politicians, in heeding these warnings made us fall prey to this situation. Replaying an error that has brought about so many casualties should not occur again if we heed warnings and take measures to protect ourselves. If we do not learn from history, we are doomed to repeat it.

Similar to many adept writers, Honigsbaum weaves captivating reports of the pandemic instances of the 20th and 21st centuries. He goes into the premise, first noticing, significance and strength, prominence, spread, symptoms, variances of the outbreaks. He supplements his findings with thoroughly researched data from vast, influential sources. His expert narration makes the narrators feel like their traveling the world and traveling through different times. We are transported from the pollutant-infested atmosphere in a Mexican quarter in LA from 1924 to the town of Recife, Brazil in the more recent year, 2008. The book ends on an ominous note with Honigsbaum stating that "The only certain thing is that there will be new plagues and new pandemics. It is not a question of if, but when." No matter how sophisticated our technologies become, or no matter how much we learn or choose to learn from the past, "Pestilences may be unpredictable, but they will occur.” (Honigsbaum 2020: 283).

Despite a careful analysis of socially constructed nature of pandemics and the focus that the author places on public health response, if there is one shortcoming in the analysis, it is that it lacks any discussion on political economy forces that shape pandemics. While there can be no denying that governance failures are important in determining what shapes pandemics and how much damage they cause, the successes and failures of governance responses must also be placed in the context of material forces that underlie societies. Any analysis undertaken of what has transpired over the last few years would be woefully incomplete without also considering these material forces that shape pandemics. Unfortunately, these issues find little attention in Honigsbaum’s book.  To take an example, it has become increasingly evident that developing countries are facing an acute shortage of covid-19 vaccines. These shortages stem not so much from actual supply-side limitations as much as from profit-hungry multi-national pharmaceutical monopolies that have used their positions in markets, their control over vaccine patents, and their clouts in global governance bodies to severely curtail the flow of vaccines to developing nations with devastating consequences for the latter (Stiglitz and Wallach 2021). Thus, even as covid-19 has decimated economies and hurt the most vulnerable sectors of society, those at the top of the income ladder have become richer, so much so that in the ten-month period following global lockdowns that began in March 2020, “the world’s 10 richest billionaires have collectively seen their wealth increase by $540bn” (Berkhout et al. 2021: 12). Thus, even as the ongoing pandemic has laid bare the importance of public health responses, they have also exposed underlying power asymmetries between and within nations across the world.

This shortcoming notwithstanding, This riveting book provides a deep understanding of how a disease gains momentum and becomes a pandemic; it focuses attention on public health efforts, the role of expertise of medical researchers, health officials, and officers. To those with a curiosity and regard for economics, history, sociology, and biology I would recommend you give this book a read.

References

Baldwin, R., and Di Mauro, B. W. (2020). Economics in the time of COVID-19, London: CEPR Press.

Berkhout, E., Galasso, N., Lawson, M., Morales, P.A.R, Taneja, A. and Pimentel, D.A.V. (2021). The Inequality Virus, Policy Papers, Oxfam International

Macron, E (2020) Macron: Time to think the unthinkable. The Financial Times, 17 April. Available at: ft.com/content/55ba601d-073e-4c3c-8f6b-2d51408466f9

Saravelos, G (2020) The end of the free market: Impact on currencies and beyond. Deutsche Bank, 17 April. Available at: dbresearch.com/servlet/reweb2.ReWEB?rwsite=RPS_EN PROD&rwobj=ReDisplay.Start.class&document=PROD0000000000507163

Snowden, F.M. (2019). Epidemics and Society: From the Black Death to the Present, Yale University Press

Crawford, D.H. (2011). Viruses: A Very Short Introduction, Oxford University Press

Ghosh, J. (2020). A critique of the Indian government’s response to the COVID-19 pandemic. Journal of Industrial and Business Economics, 47, 519–530.

Stiglitz, J.E. and Wallach, L. (2021). Will Corporate Greed Prolong the Pandemic? Project Syndicate Available at: project-syndicate.org/onpoint/big-pharma-blocking-wto-waiver-to-produce-more-covid-vaccines-by-joseph-e-stiglitz-and-lori-wallach-2021-05