The Premonition: A Pandemic Story

Book Preface

This book began with an unholy mix of obligation and opportunism. During the first half of the Trump administration I’d written a book, The Fifth Risk, that framed the federal government as a manager of a portfolio of existential risks: natural disasters, nuclear weapons, financial panics, hostile foreigners, energy security, food security, and on and on and on. The federal government wasn’t just this faceless gray mass of two million people. Nor was it some well-coordinated deep state seeking to subvert the will of the people. It was a collection of experts, among them some real heroes, whom we neglected and abused at our peril. Yet we’d been neglecting and abusing them for more than a generation. That behavior climaxed with the Trump administration. My book asked: What happens when the people in charge of managing these risks, along with the experts who understand them, have no interest in them?

I had no clue what was going to happen next. I assumed something was bound to happen. But it didn’t—not really. For the better part of three years, the Trump administration got lucky. That luck ran out in late 2019, as a freshly mutated virus in China made its way toward the United States. This was just the sort of management test I’d imagined when writing The Fifth Risk. How could I not write about it? But as I got into it, and found these wonderful characters to tell the story through, it became clear that Trump’s approach to government management was only a part of the story, and maybe not even the bigger part. As one of my characters put it, “Trump was a comorbidity.”

Back in October 2019—nearly three years into the Trump administration, and before anyone involved was aware of the novel coronavirus—a collection of very smart people had gathered to rank all the countries in the world, in order of their readiness for a pandemic. A group called the Nuclear Threat Initiative partnered with Johns Hopkins and The Economist Intelligence Unit to create what amounted to a preseason college football ranking for one hundred ninety-five countries. The Global Health Security Index, it was called. It was a massive undertaking involving millions of dollars and hundreds of researchers. They created stats and polled the experts. They ranked the United States first. Number 1. (The United Kingdom was Number 2.)

Critics quibbled with the rankings. The complaints weren’t all that different from the complaints you hear before every college football season. For years the University of Texas football team, with its vast resources and sway with voters, always seemed ranked more highly at the start of the season than at the end. The United States was the Longhorns of pandemic preparedness. It was rich. It had special access to talent. It enjoyed special relationships with the experts whose votes determined the rankings.

Then the game was played. The preseason rankings no longer mattered. Neither, really, did the excuses and blame-casting and rationalizations. As the legendary football coach Bill Parcells once said, “You are what your record says you are.” At last count the United States, with a bit more than 4 percent of the world’s population, had a bit more than 20 percent of its COVID-19 deaths. In February 2021, The Lancet published a long critique of the U.S. pandemic performance. By then 450,000 Americans had died. The Lancet pointed out that if the COVID death rate in the United States had simply tracked the average of the other six G7 nations, 180,000 of those people would still be alive. “Missing Americans,” they called them. But why stop there? Before the pandemic, a panel of public-health experts had judged the United States to be more prepared for a pandemic than other G7 nations. In a war with a virus, we were not expected merely to fare as well as other rich countries. We were expected to win.

I like to think that my job is mainly to find the story in the material. I always hope that story will wind up being about more than what I think it’s about—and that the reader will bring to it his own sense-making apparatus and find meanings in it missed by its author. But that doesn’t mean that I don’t form some opinion of what it’s about. I think this particular story is about the curious talents of a society, and how those talents are wasted if not led. It’s also about how gaps open between a society’s reputation and its performance. After a catastrophic season, management always huddles up to figure out what needs to be changed. If this story speaks to that management in any way, I hope it is to say: There are actually some things to be proud of. Our players aren’t our problem. But we are what our record says we are.