H5N1

Goodbye, Johns Hopkins covid tracker

Via The Washington Post: Goodbye, Johns Hopkins covid tracker. Excerpt:

When the pandemic hit, the federal government struggled to publish snapshots of the virus’ spread.  

So, academics and journalists quickly filled the void, creating new tools with near real-time estimates of the unfolding pandemic. Since January 2020, Johns Hopkins University has operated one of the most prominent resources for tracking covid-19 case counts and deaths across the world.   

After more than three years, the university will stop updating its tracker on March 10 as the country has moved into a different stage of the pandemic with a different data flow. But the story of the online dashboard — a $13 million project that’s been viewed over 2.5 billion times — is more than just about a tool to track the pandemic. It underscores the country’s fragmented public health systems and its decentralized and underfunded reporting system, which hobbled the U.S. pandemic response.    

“The thing that became the biggest surprise was the importance and reliance on it by everyone: by the general public and decision-makers and everyone in between,” said Lauren Gardner, the director of the Johns Hopkins Center for Systems Science and Engineering who started the global tracker with one of her PhD students.  

“Hopkins filled a gap that nobody else was able to do,” Ali Mokdad, a professor of health metrics sciences at University of Washington’s IHME. “So all of us, reporters, us in academia, we went to Hopkins to get the data.”  

Why now?  

The Johns Hopkins researchers point out that they don’t believe the pandemic has ended — and the move to stop updating the tracker shouldn’t be conflated as such. Instead, the decision comes amid a different phase of the pandemic and was made for two main reasons.   

The first: The Centers for Disease Control and Prevention and the World Health Organization have built up their capacity to share covid data with the general public, which Gardner called the “appropriate” entities to be providing this information long term.   

The second: The quality of the tracker depends on the quality of publicly available data. At the beginning of the pandemic, states, counties and even cities were providing daily covid updates, which scrapers for the tracker could collect data from. But that’s not the case anymore, and that has a direct impact on what the dashboard can do.   

Looking forward  

The country has made some improvements on its data collection efforts, but there’s still a ways to go, according to several experts.   

Beth Blauer, an associate vice provost at Johns Hopkins University who helped run the Coronavirus Resource Center, said that many states closed up their covid reporting with little information on any next steps.  

“Our big question is whether or not they’re making long-term investments in critical public health data infrastructure to navigate lots of challenges that they face,” Blauer said, citing the opioid epidemic and economic mobility. 

WHO meets with Chinese officials on current COVID-19 situation

A statement by WHO: WHO meets with Chinese officials on current COVID-19 situation. Evidently WHO has run out of praise for China's response:

A high-level meeting took place on 30 December between WHO and China about the current surge in COVID-19 cases, to seek further information on the situation, and to offer WHO's expertise and further support.  

High-level officials from China's National Health Commission and the National Disease Control and Prevention Administration briefed WHO on China's evolving strategy and actions in the areas of epidemiology, monitoring of variants, vaccination, clinical care, communication and R&D.   

WHO again asked for regular sharing of specific and real-time data on the epidemiological situation — including more genetic sequencing data, data on disease impact including hospitalisations, intensive care unit (ICU) admissions and deaths — and data on vaccinations delivered and vaccination status, especially in vulnerable people and those over 60 years old.  WHO reiterated the importance of vaccination and boosters to protect against severe disease and death for people at higher risk.    

WHO called on China to strengthen viral sequencing, clinical management and impact assessment, and expressed willingness to provide support on these areas, as well as on risk communications on vaccination to counter hesitancy. Chinese scientists are invited to engage more closely in WHO-led COVID-19 expert networks including the COVID-19 clinical management network. WHO has invited Chinese scientists to present detailed data on viral sequencing at a meeting of the Technical Advisory Group on SARS-CoV-2 Virus Evolution on 3 January.  

WHO stressed the importance of monitoring and the timely publication of data to help China and the global community to formulate accurate risk assessments and to inform effective responses.

US CDC begins agency-wide changes after pandemic failures

Via The Lancet: US CDC begins agency-wide changes after pandemic failures. Excerpt:

The US Centers for Disease Control and Prevention (CDC) is on a mission to reorganise and modernise itself, so that its mistakes during the pandemic will not happen again. The aim is to make the nation's leading disease detective more nimble and accountable, and fortify its role as public health protector. But although some changes have been made, progress will be limited without support from the US Congress. 

The CDC's Director, Rochelle Walensky, an infectious disease physician and research scientist appointed by President Joe Biden in January, 2021, commissioned an independent review of the CDC's pandemic record in April, conducted by James McCrae, Associate Administrator for Primary Health Care in the Department of Health and Human Services’ Health Resources and Services Administration. “To be frank, we are responsible for some pretty dramatic, pretty public mistakes, from testing to data to communications”, Walensky told her roughly 11 000 staff when she unveiled a summary of the review's findings in August (panel).  

Panel  

Key findings and recommendations from the CDC review  

It takes too long for the CDC to publish its data and science for decision making  

• Create an online mechanism for pre-publication delivery of science  

• Expedite the review or approval process for scientific publications and data (including laboratory data) to match the needs of the emergency  

The agency's turnover of staff during the COVID-19 response created gaps and other challenges for partners   

• Increase the number of CDC leaders trained and ready to deploy to a response  

• Require a minimum of 6-month rotation for leadership positions on the response; build a redundancy model of emergency staffing (ie, backup or co-lead staff in all key positions) to prevent response burnout and assure continuity in operations  

The agency's guidance documents are confusing and overwhelming, and the website is not easy to navigate  

• Produce plain-language, easy-to-understand implementation guidance documents that apply over multiple settings; reduce the number and length of guidance documents; include a brief scientific rationale or background in the implementation guidance with a referenced or accompanying Morbidity and Mortality Weekly Report, Science Brief, as necessary  

• Restructure the agency web site and digital communication platforms to eliminate unnecessary content and focus on key target audiences with a primary emphasis on the public  

COVID-19 uncovered the need for flexibilities that do not exist today at the CDC  

• Establish new authorities that will allow the CDC to be more nimble and work faster, such as public health and regulatory authorities mandating data collection from local jurisdictions, and human resource authorities with authority to hire faster, and ensure competitive salaries to recruit and retain for hard-to-fill positions like data scientists

A multinational Delphi consensus to end the COVID-19 public health threat

Via Nature: A multinational Delphi consensus to end the COVID-19 public health threat. The abstract:

Despite notable scientific and medical advances, broader political, socioeconomic and behavioural factors continue to undercut the response to the COVID-19 pandemic. Here we convened, as part of this Delphi study, a diverse, multidisciplinary panel of 386 academic, health, non-governmental organization, government and other experts in COVID-19 response from 112 countries and territories to recommend specific actions to end this persistent global threat to public health.  

The panel developed a set of 41 consensus statements and 57 recommendations to governments, health systems, industry and other key stakeholders across six domains: communication; health systems; vaccination; prevention; treatment and care; and inequities.  

In the wake of nearly three years of fragmented global and national responses, it is instructive to note that three of the highest-ranked recommendations call for the adoption of whole-of-society and whole-of-government approaches, while maintaining proven prevention measures using a vaccines-plus approach that employs a range of public health and financial support measures to complement vaccination.  

Other recommendations with at least 99% combined agreement advise governments and other stakeholders to improve communication, rebuild public trust and engage communities in the management of pandemic responses.  

The findings of the study, which have been further endorsed by 184 organizations globally, include points of unanimous agreement, as well as six recommendations with >5% disagreement, that provide health and social policy actions to address inadequacies in the pandemic response and help to bring this public health threat to an end.

WHO: Ghana reports first-ever suspected cases of Marburg virus disease

Via WHO AFRO:Ghana reports first-ever suspected cases of Marburg virus disease. The news release and then a comment:

Accra – Ghana has announced the preliminary finding of two cases of Marburg virus disease and if confirmed these would the first such infections recorded in the country. Marburg is a highly infectious viral haemorrhagic fever in the same family as the more well-known Ebola virus disease.   

Preliminary analysis of samples taken from two patients by the country’s Noguchi Memorial Institute for Medical Research indicated the cases were positive for Marburg. However, per the standard procedure, the samples have been sent to the Institut Pasteur in Senegal, a World Health Organization (WHO) Collaborating Centre for confirmation. The two patients from the southern Ashanti region – both deceased and unrelated – showed symptoms including diarrhoea, fever, nausea and vomiting. They had been taken to a district hospital in Ashanti region.   

Preparations for a possible outbreak response are being set up swiftly as further investigations are underway.  

“The health authorities are on the ground investigating the situation and preparing for a possible outbreak response. We are working closely with the country to ramp up detection, track contacts, be ready to control the spread of the virus,” said Dr Francis Kasolo, World Health Organization (WHO) Representative in Ghana.  

WHO is deploying experts to support Ghana’s health authorities by bolstering disease surveillance, testing, tracing contacts, preparing to treat patients and working with communities to alert and educate them about the risks and dangers of the disease and to collaborate with the emergency response teams.  

If confirmed, the cases in Ghana would mark the second time Marburg has been detected in West Africa. Guinea confirmed a single case in an outbreak that was declared over on 16 September 2021, five weeks after the initial case was detected.  

Previous outbreaks and sporadic cases of Marburg in Africa have been reported in Angola, the Democratic Republic of the Congo, Kenya, South Africa and Uganda.  

Marburg is transmitted to people from fruit bats and spreads among humans through direct contact with the bodily fluids of infected people, surfaces and materials. Illness begins abruptly, with high fever, severe headache and malaise. Many patients develop severe haemorrhagic signs within seven days. Case fatality rates have varied from 24% to 88% in past outbreaks depending on virus strain and case management.  

Although there are no vaccines or antiviral treatments approved to treat the virus, supportive care – rehydration with oral or intravenous fluids – and treatment of specific symptoms, improves survival. A range of potential treatments, including blood products, immune therapies and drug therapies, are being evaluated.

When I hear of an outbreak like this, I go straight to the affected country's media and ministry of health. Too often, I find the media have nothing on the story (or the websites aren't accessible) and neither does the ministry. It was a big problem early in the West African Ebola outbreak, though the media and most of the health ministries finally began to provide prompt, reliable information.

I hope this Marburg outbreak will be brief, but also that it will push the Ghanaian government to pay more attention to health communication in general—and to its online communication in particular.

ECDC risk assessment: Monkeypox multi-country outbreak

ECDC has published Risk assessment: Monkeypox multi-country outbreak. Click or tap through to download the full report. The executive summary, with my bolding:

Key messages  

Monkeypox (MPX) does not spread easily between people. Human-to-human transmission occurs through close contact with infectious material from skin lesions of an infected person, through respiratory droplets in prolonged face-to-face contact, and through fomites. The predominance, in the current outbreak, of diagnosed human MPX cases among men having sex with men (MSM), and the nature of the presenting lesions in some cases, suggest transmission occurred during sexual intercourse.  

Based on ECDC’s epidemiological assessment, the likelihood of MPX spreading in persons having multiple sexual partners in the EU/EEA is considered high. Although most cases in current outbreaks have presented with mild disease symptoms, monkeypox virus (MPXV) may cause severe disease in certain population groups (young children, pregnant women, immunosuppressed persons). However, the likelihood of cases with severe morbidity cannot be accurately estimated yet. The overall risk is assessed as moderate for persons having multiple sexual partners (including some groups of MSM) and low for the broader population.  

Treatment is mainly symptomatic and supportive, including prevention and treatment of secondary bacterial infections. Smallpox vaccine can be considered for post-exposure prophylaxis of close contacts at increased risk for severe disease, however careful benefit/risk assessment should be performed for the exposed individual. Important information on the use of currently available smallpox vaccines is missing for groups at increased risk for severe disease. In addition, antivirals are potential treatment options for severe cases.  

EU/EEA countries should focus on prompt identification, management, contact tracing and reporting of new MPX cases. Countries should update their contact tracing mechanisms, their diagnostic capacity for orthopoxviruses and review the availability of smallpox vaccines, antivirals and personal protective equipment (PPE) for health professionals.  

An interim case definition is proposed for case reporting. Guidance for the management of MPX cases and close contacts is also included. Cases should remain isolated until their rash heals completely, avoiding contact with immunosuppressed persons and pets. Abstaining from sexual activity and close physical contact is also advised until the rash heals. Most cases can remain at home with supportive care.  

Close contacts of MPX cases should self-monitor for the development of symptoms up to 21 days from the last exposure to a case.  

Healthcare workers should wear appropriate PPE (gloves, water-resistant gown, FFP2 respirator) when screening suspected cases or caring for a MPX case. Laboratory personnel should also take precautions to avoid occupational exposure.  

Close contacts of a MPX case should be deferred from blood, organ or bone marrow donations for a minimum of 21 days from the last day of exposure.  

Proactive risk communication and multiple community engagement activities should be carried out to increase awareness, provide updates and guidance to those at increased risk and the wider public. Risk communication messages should stress that MPXV is spread through close contact between people, especially in the same household, potentially including the sexual route. A balance should be kept between informing those most at risk but also communicating that the virus does not spread easily between people the risk to the broader population is low.  

There is a potential risk of human-to-animal transmission in Europe, therefore close intersectoral collaboration between human and veterinary public health authorities working from a ‘One Health’ perspective is needed to manage exposed pets and prevent the disease from being transmitted in wildlife. EFSA is not aware to date of any reports on infections in animals (pets or wild animals) in the EU.  

Several unknowns still exist regarding this outbreak and ECDC will continue to monitor developments closely and update the risk assessment as new data and information become available.

A turning point in coverage of COVID data

Via the Columbia Journalism Review, a column by Jon Allsop: A turning point in coverage of COVID data. Click through for the full article and many links. Excerpt:

There's important information down the toilet—and no, I’m not talking about sensitive documents from the Trump White House. Early this month, the Centers for Disease Control and Prevention updated its online COVID data tracker to include wastewater analyses from hundreds of communities across the US, information that can serve as an early indicator of increased viral spread, or the circulation of a new variant, given that people shed the virus via their feces without having to take and report a test result. (Wastewater data is also collective, obviating privacy issues inherent to other forms of medical-data reporting.) 

Wastewater experts who spoke with Apoorva Mandavilli, a reporter at the New York Times, were “understanding” of the fact that it took the CDC so long to publicly share data that it was, in some cases, already collecting. Not everyone shared that assessment, though. Robinson Meyer, a journalist at The Atlantic who co-founded the COVID Tracking Project to fill the gap left by official data shortages early in the pandemic, called the delayed publication “a scandal.”  

It’s not just wastewater—as Mandavilli reported over the weekend, it turns out that the CDC “has published only a tiny fraction of the data it has collected” during the pandemic. The agency has tracked data breaking down hospitalization stats by age, race, and vaccination status for more than a year now but has mostly not published it; when officials shared data on the effectiveness of vaccine boosters recently, they left out the figures for a huge tranche of younger recipients until the Times inquired.  

CDC representatives told Mandavilli that the agency withholds data for a variety of reasons, from the numbers being “not yet ready for prime time” to the agency’s slow and cumbersome bureaucracy as well as a fear that the public might misinterpret certain trends, particularly where the hospitalization of vaccinated people is concerned.  

Jessica Malaty Rivera, who has also worked with the Tracking Project, slammed the latter rationale, in particular, noting that rather than reduce the risk of misinterpretation, “data vacuums” only heighten it. So, too, did Meyer, who called such attitudes not only “counterproductive” but “profoundly undemocratic.” The “approach has now persisted in the CDC across two presidents,” he noted. “It’s an issue with that agency—and with the overweeningly scholastic culture of public health in the US.” 

The availability of good, timely data has been a persistent challenge for the press throughout the pandemic, as I’ve explored many times in this newsletter. So, too, has knowing how best to relay the data that we do have to our audiences. The recent Omicron wave sharpened the challenge again by posing a different type of threat than prior variants: low for most individuals, especially the vaccinated, but sharp for many immunocompromised and unvaccinated people as well as at the collective level of US healthcare infrastructure, given the variant’s high transmissibility.

Even before Omicron, some health officials and experts had urged news outlets to emphasize hospitalization and death rates more than case counts in their coverage, as mass vaccination frayed the previously close link between those numbers; as Omicron further frayed the link, those calls intensified. If Omicron cast fresh doubt on the usefulness of case counts, it also cast fresh doubt on their accuracy, as testing—which was not adequate to make US case counts fully reliable to begin with—became harder to access and many people neglected to report at-home results. The Associated Press, among other outlets, told staffers to be more cautious around case counts, and not to hype supposed new records by writing whole stories about them.

Future pandemics: Failing to prepare means preparing to fail

An editorial in The Lancet Respiratory Medicine: Future pandemics: failing to prepare means preparing to fail.

Governments of high-income countries with high SARS-CoV-2 vaccination rates have been encouraged by evidence of decreasing COVID-19-associated morbidity and mortality, and can begin to think about the change from pandemic to endemic and the prevention of future pandemics. Meanwhile, some low-income and middle-income countries (LMICs) are still grappling with high numbers of COVID-19 cases, hospitalisations, and deaths, and low vaccination rates. 

A similar pattern has been seen with previous pandemics, including HIV/AIDS, tuberculosis, and malaria. Although these diseases kill millions of people globally every year, they are often referred to as endemic. As stated by Prof Ali Zumla in a recent Perspectives article, “The pandemic exposes weaknesses of current leadership of global public health systems, inequities of resource allocation to Africa, and broken promises by wealthier nations for vaccine equity and resource allocation. This status quo is unacceptable.” 

Rather than allowing a splintering of attention and resources across the COVID-19 pandemic, other current pandemics, and future threats, we should move towards an integrated, multipronged approach that targets these threats collectively. We must learn from the way in which different countries responded to the COVID-19 pandemic and build on successful approaches to ensure equitable pandemic preparedness in the future. Tackling a pandemic requires a global response. Individual countries need to prepare, but success will be hindered if some countries are left without the capacity to respond to a new threat. 

An analysis in the BMJ examined 28 national responses in the first year of the COVID-19 pandemic. Countries that were considered to be high performing were able to “partner, coordinate, develop, and strengthen” various public health, health-care system, and socioeconomic measures. Ultimately, these actions led to decreased disease transmission and lower mortality rates. Government cooperation, effective community engagement, and coordination across all levels of response led to successful procurement of resources and transformation from evidence-based policy to practice. 

A recent Global Burden of Disease study also found that measures of trust in government, and less government corruption, were associated with lower infection rates and higher SARS-CoV-2 vaccination coverage in middle-income and high-income countries. Therefore, efforts to improve communication surrounding risk of disease and community engagement strategies could help to boost public confidence in pandemic response strategies. 

Low-performing countries identified in the BMJ analysis had four common themes: devaluation of effective pandemic preparedness plans through inadequate infrastructure and underfunded health systems; denial from heads of state of scientific evidence that COVID-19 was a severe risk to health, and lack of support for those most vulnerable to economic risks of COVID-19; delays in enacting rapid responses to different stages of the pandemic despite supporting evidence; and finally, distrust between the public, government leaders, and the scientific research community. Unfortunately, these factors have been compounded by the politicisation of many actions, including the use of facemasks and vaccines. 

At present, many countries are severely underprepared to enact any plans for future pandemic prevention or response. They face numerous challenges in providing universal health coverage for citizens and are not able to allocate adequate investment or resources towards, for example, an increased workforce equipped to deal with current or future pandemics.

The Global Fund is actively involved in pandemic preparedness and response with their COVID-19 Response Mechanism (C19RM), which provides grant support to LMICs for COVID-19 tests, treatments, personal protective equipment, and critical elements of health system strengthening. C19RM aims to mitigate the impact of COVID-19 on programmes to fight HIV, tuberculosis, and malaria, and initiates urgent improvements in health and community systems; as of Jan 25, 2022, total funds approved to support C19RM reached US$4·1 billion, made available through support from donors in the USA, Germany, the Netherlands, and Switzerland. The hope is that funding will not be diverted from current pandemic action and that separate income will be generated for future threats.

Increased investment in COVID-19 tests, treatments, and vaccines has been extraordinary. To fully prepare for future pandemics, investment in mechanisms to prevent, detect, and respond to emerging pathogens is crucial.

Helen Branswell talks with Mike Ryan

Via STAT, Helen Branswell interviews Mike Ryan, head of WHO's health emergencies program: WHO official weighs in on Covid, vaccines, and mistakes that were made. This excerpt is a key part of an interview you should read in its entirety:

Are there things you wish the world had done differently from the jump? Where did we make our biggest mistakes? 

This interview could go on for a while.        

The biggest collective failing has been that we’ve underestimated this microbe. We’ve always made judgments assuming the best-case scenario. And I’m not one for assuming the worst-case scenarios as a modus operandi, because otherwise, you can strangle society. But I think at every opportunity we’ve seem to have taken the best-case scenario as the basis for our policy. And this virus, I think, has sequentially exploited that.  

In the end, the virus doesn’t have a brain. It’s just, from an evolutionary point of view, exploiting opportunities. And we seem to have consistently and persistently given it the opportunity.  

There’s been tremendous social, economic, and political pressure to go back to normal.   

Time and time again governments have tried to get back to normal and have overshot that runway by opening up too early. Releasing restrictions too early. They haven’t really convinced people or empowered people to continue with these basic measures to reduce the risk of infection. I think that’s been a problem, the whole way through the pandemic.  

I don’t mean getting rid of lockdowns. To me lockdowns have been last resort measures in most cases. Many countries in the East have managed to forgo lockdowns. But they’ve maintained quite strict measures in terms of mask wearing, in terms of crowds, in terms of testing and other stuff. So they’ve taken a much more comprehensive, layered strategy. They’ve maintained an intensity of control measures without ever going for full lockdown, without ever going for full open. They’ve taken the corner without under- or over-steering.  They’ve gotten people to buy into the idea that it’s going to take a long time and it’s going to have to be a sustained effort. I think if everyone had done that maybe we’d be in a better place.   

But I think for me just personally as a public health physician, the biggest tragedy has been the vaccine equity issue. It really has been horrific. Horrific. The world just has not ever come to terms with the fact that vaccinating the most vulnerable people first would have been a better bet, not only epidemiologically but just from an equity perspective.   

The idea of coherence and coordination and solidarity — these are all lovely words. But it’s very hard to deliver that in societies that don’t trust governments, [don’t buy into] that social contract, that inherent trust that a community should have in its government to say, “Yes, you are there to protect me.”  

What’s shocked me most in this pandemic has been that absence or loss of trust.  

It’s staggering to read about public health personnel quitting their jobs, being subjected to death threats during a pandemic. They’re facing hatred and vitriol from the people they’re trying to protect.   

It’s tragic. And it’s tragic to think that there are millions of people right now in the Northern Hemisphere who are not vaccinated because they don’t believe their government. Whatever the reasons for that are, whether it’s because governments perform poorly in building that trust, or whether they’ve been actively undermined by misinformation and by other things, historians and social historians will be talking about that one for decades.   

If we’re looking at pandemic preparedness for the future it’s not all going to be about technology and the machines that go ping and surveillance systems and AI and all of this stuff. We need a social solution for future pandemics, much more than we need a technological solution. Because we’re dealing with a fractured world, fractured communities. We’re dealing with a breach and prolonged breakdown in trust.

I shudder to think of going into a more severe pandemic with that level of community distrust. It has had a real negative impact on people’s awareness and willingness to sustain measures. Because they can constantly find lots of material and reasons not to do what they’re being asked to do, because there’s so much out there telling them that what’s going on there is a government conspiracy, what’s happening is hurting them.

Reading about COVID-19

Early next year, I'll be teaching "Perspectives on Pandemics," a course for Eldercollege here on the North Shore—going back to the Athenian and Justinianic plagues and the Black Death, but focusing on COVID-19. I'm pulling together a suggested reading list for my students, and it occurred to me that others might want to explore some of these titles as well. So here they are. Some include links to my Tyee reviews; others will be mentioned in a long article I'm working on. I'll update this list from time to time.

Peter Baldwin, Fighting the First Wave: Why the Coronavirus Was Tackled So Differently Across the Globe. Cambridge University Press, 2021. My review: https://thetyee.ca/Analysis/2021/03/30/Best-Book-Written-About-COVID-Pandemic/

Alex De Waal, New Pandemics, Old Politics: Two Hundred Years of War on Disease and Its Alternatives. Polity Press, 2021. My review: https://thetyee.ca/Culture/2021/07/09/All-Plagues-Are-Political/

Elaine Dewar, On the Origin of the Deadliest Pandemic in 100 Years: An Investigation. Biblioasis, 2021.

Fang Fang, Wuhan Diary: Dispatches from a Quarantined City, translated by Michael Berry. HarperCollins, 2020. My review: https://thetyee.ca/Culture/2020/05/27/Wuhan-Diary-Book/

Richard Horton, The Covid-19 Catastrophe: What’s Gone Wrong and How to Stop It Happening Again. Polity Press, 2020. My review: https://thetyee.ca/Culture/2020/06/22/Only-Newly-Vigilant-Society-Can-Stop-Next-Pandemic/

Colin Kahl & Thomas Wright, Aftershocks: Pandemic Politics and the End of the Old International Order. St. Martin’s Press, 2021.

Michael Lewis, The Premonition. W.W. Norton, 2021. My review: https://thetyee.ca/Culture/2021/05/18/Hot-Pandemic-Book-Poses-Danger/

Rupa Marya & Raj Patel, Inflamed: Deep Medicine and the Anatomy of Injustice. Farrar, Straus & Giroux, 2021.

Jon Sternfeld, Unprepared: America in the Time of Coronavirus. Bloomsbury, 2021. My review: https://thetyee.ca/Culture/2020/12/22/Unprepared-America-Time-Coronavirus-Book/

Steven Taylor: The Psychology of Pandemics: Preparing for the Next Global Outbreak of Infectious Disease. Cambridge Scholars Publishing, 2019. My review: https://thetyee.ca/Culture/2020/07/10/Mental-Toll-Covid-Doctors-Saw-Coming/

Adam Tooze, Shutdown: How Covid Shook the World’s Economy. Viking 2021.

Lawrence Wright, The Plague Year: America in the Time of COVID. Alfred A. Knopf, 2021.