Down and Outbreak

Breathless: The Scientific Race to Defeat a Deadly Virus BY DAVID QUAMMEN. NEW YORK: SIMON & SCHUSTER. 416 PAGES. $30.
Cover of Breathless: The Scientific Race to Defeat a Deadly Virus

IN THE FALL of 2019, I wrote in these pages: “It remains unlikely that Ebola will spark a global pandemic. But it is almost certain that something else will, and there is every danger that it will exacerbate prevailing social tensions.” The occasion was two books about the 2013–2014 Ebola outbreak in West Africa. Each author, Richard Preston and David Quammen, warned of the “Next Big One,” as Quammen put it, which could well be “an inevitability.” People tend to forget Cassandra was right.

Quammen’s new study opens a few months after I wrote those sentences, when reports of a “pneumonia of unknown cause” began to trickle out of Wuhan. The first sentence of Breathless is: “To some people it wasn’t surprising, the advent of this pandemic, merely shocking in the way a grim inevitability can shock.” There were to be a number of surprises as the SARS COV-2 pandemic unfolded—who knew the CDC was such a shit show?—but that it happened should not have been among them, and it wouldn’t have been, had we but listened. Laurie Garrett published The Coming Plague in 1994, warning that humanity, having been “lulled into a complacency born of proud discoveries and medical triumphs” was “unprepared for the coming plague.” “Nobody had any idea,” said Donald Trump in March 2020, which, like most things he says, was either a lie or pig-ignorant.

I spent the spooky spring of 2020 staring out the window of my Brooklyn apartment at a ghost world. A couple of times I watched corpses wheeled from buildings on my street. The birds seemed louder, though I knew it was just that everything else was quieter. I obsessively checked the Times for updates about the increasingly ominous situation, until I read that Central Park had been turned into a makeshift morgue, at which point I decided I was better off not knowing. I listened to a lot of black metal, pacing up and down my apartment. I worried about touching groceries. I worried about my sixteen-year-old cat (who made it, in the end, almost to nineteen). I worried about my family. I worried about every slight sneeze, each passing odd sensation. I called everyone I know and talked all night. I went crazy.

And I survived, without losing anyone, which is more than far too many can say. 

The first reports of the novel coronavirus hit the internet at the very end of December 2019; by January 3 its entire genome had been sequenced. Then came the waves, the lockdowns, the mass graves, the mass cremations, the variants. And the denials, the protests, the conspiracy theories. Breathless is a chronological account of the science side of all this, its research conducted via interviews (mostly over Zoom) with scientists, public-health officials, the central players: virologists, professors, molecular biologists, physicians, epidemiologists, anthropologists. The “credits” at the end of the book—brief bios of interviewees—run to forty-three pages. 

Paul P., Untitled, 2021, watercolor on paper, 6 3/4 x 9 5/8". Courtesy Queer Thoughts, New York.
Paul P., Untitled, 2021, watercolor on paper, 6 3/4 x 9 5/8″. Courtesy Queer Thoughts, New York.

There’s no question that Quammen is the guy for such a book. I think he’s the best science writer alive, which, though most science writing is bad, is not intended as faint praise. My favorite of his books, 2012’s Spillover, is a terrifying compendium of zoonotic diseases—those caused by pathogens that “spill over” from a host animal into another species, in this case into humans from wildlife—including Ebola, HIV, the original SARS, etc. SARS COV-2, like most scary-ass viruses, probably came from bats. I like bats, bats are great, but what the hell.

I don’t want to spend too much time recounting the actual, you know, science, because I’d just get something wrong. Suffice it to say that Quammen is a skilled explainer, laying out, for instance, the intricate workings of RNA viruses without condescending to his audience or leading it too far into the weeds. Before reading Breathless I had only the fuzziest idea of what a receptor binding domain was or did, and I could have told you that the furin cleavage site is the thingy that helps the virus latch onto cells, but if you’d said, OK, but what is it, I’d have been like, “Um, proteins . . . enzymes??” 

Quammen is even better on the tantalizing mysteries and puzzles of the pandemic: the identification of the virus in Italy, France, and Brazil in human samples taken in late autumn 2019, before the earliest reported cases appeared in Wuhan; satellite data showing a big increase of hospital occupancy in Wuhan in August 2019; and, of course, the lab-leak theory.

Did the novel coronavirus that causes COVID-19 arise within an animal, most likely a damn bat, as the vast majority of scientists believe? Or—dun dun DUNN—did it originate in and then escape (“leak” adds alliterative value) from a laboratory, say the Wuhan Institute of Virology? As Quammen nicely puts it, comparing the question to a Rorschach test: “Some people will look at this inkblot and see a bat. Others will look at it and see a laboratory.”

Many of those seeing a lab (such as Nicholson Baker in New York magazine) did so in good faith. It is not unreasonable to ask whether the lab working on bat coronaviruses had something to do with the bat-coronavirus outbreak at the Huanan “wet” wildlife market ten miles away. But no aspect of this pandemic stays not unreasonable for long. For some the lab-leak theory became an excuse to indulge in the vilest racism—I forbear from citation—and some have made it clear that no amount of countervailing evidence of a natural origin will sway them, not with precious social-media clout at stake.

Anyway, it’s hardly as if a natural origin of SARS COV-2 is far-fetched. As the evolutionary biologist Edward C. Holmes told Quammen, “You can’t think of a better place for a zoonotic event to happen” than the Huanan market, which sits squarely within a city of eleven million people. Mix “narrow alleys crowded with people, the wildlife in cages, the butchering of meat and fish, the blood and guts flowing in open drains” together for long enough, and you’ll get spillover. You just will. It’s only a question of what and when. The original SARS outbreak was also traced to a wet market, and wet markets have been identified as major sources of the incredibly pathogenic H5N1 influenza virus.

And once a virus gets loose in a sufficiently large naive population, well, “RNA viruses mutate faster than almost any other sort of creature on Earth, . . . about a thousand times faster than animals.” Most of these mutations are either insignificant or dead ends, but some, by chance, enhance the virus’s fitness, perhaps its ability to spread or to evade immunity—this is “Darwin 101,” as Quammen says. Coronaviruses are also “masters of recombination,” swapping genes like kids trading baseball cards, or whatever kids trade these days.

And there’s much more, which I leave to the reader to discover, because I have a quibble. In the course of describing the vaccine rollout, after noting that “in the world’s thirty poorest countries, only 2 percent of the population were fully vaccinated” in late 2021, Quammen writes:

Pfizer and BioNTech and Moderna are for-profit companies, after all. The conundrum of intellectual property rights versus public health, common good versus the expectations of venture capitalists at play with the pharmaceutical industry, is a monster I’ll only nod at here, forgive me, and keep walking. 

Well, but you’re talking about a form of murder. The question the pharmaceutical industry poses without asking out loud is: Why should people who can’t pay get to live? Never mind that there would hardly be a pharmaceutical industry without the formerly colonized nations whose extracted resources helped to build the “advanced economies,” and whose denizens must now rely on the guilty conscience of Bill Gates. Yes, of course, without the profit motive, the vaccines would not have been developed in the first place—but that just restates the problem: the impossibility of valuing human lives equally under capitalism. No, this isn’t the question to skip over with a what-can-you-do shrug.

I’m not asking Quammen to be a different writer or to write a different book. I just think his political analysis could extend further than a few easy potshots at Trump. You shouldn’t have to read the Marxist historian Mike Davis, in his pandemic book The Monster Enters, to learn that, before the current crisis, there was little investment in vaccine production because worldwide revenue from every existing vaccine was less “than Pfizer’s income from a single anticholesterol medication,” or that it was the Obama administration that depleted, without replacing, the government’s N95 reserves, in its munificence to the private sector.

Nevertheless, and even if this book (understandably) lacks the on-the-ground gusto of Spillover, it is always a pleasure to read Quammen. In the first paragraph he describes the pandemic’s appearance to those who had long been warning of the probability of such an event as “a small, dark dot on the horizon of western Nebraska” that eventually resolves into “a runaway chicken truck.” Dad jokes are the norm in science writing—the Mertonian norm, a science-writing dad might say. Quammen, on the other hand, rarely tries too hard. (My favorite sentence, hilarious in context, is “It was a terrible burden to put on a sunroof manufacturer.”) And surely no other pandemic book will cite Faulkner, Stephen King, Robert W. Service, and the Gnostic Gospels.

Read any of Quammen’s books and you’ll learn a lot of interesting stuff and a lot of scary stuff. The scariest message of Breathless is that many, many more novel SARS-like viruses lurk in natural reservoirs (ahem, bats), minding their viral business until a new host blunders along. Eleven new strains of SARS-related coronavirus were discovered circulating in bats in a Chinese cave in 2017; three of them were already capable of infecting humans. SARS COV-3 might be just around the bend, or a thousand miles down the road, but it’s coming. And don’t think influenza is just twiddling its thumbs. As Mike Davis wrote in 2005, “human-induced environmental shocks” have created the perfect conditions for future pandemics. Throw in, for good measure, global poverty and the collapse of public-health infrastructure even in many rich countries. Some of the dark dots on the horizon will turn out to be runaway chicken trucks, and we’ve hardly learned a goddamn thing. 

Michael Robbins is the author, most recently, of the poetry collection Walkman (Penguin Books, 2021).