Preventable by Devi Sridhar review – inside the fog of war on Covid

At the end of her wide-ranging analysis of the pandemic, Devi Sridhar, professor of global public health at the University of Edinburgh, Guardian columnist and Good Morning Britain contributor, raises the dark question of whether Covid-19 will “be the spark for the third world war”.

Written before Russia’s invasion of Ukraine, Sridhar’s book is the story of a global crisis that has since been supplanted, at least in the headlines, by another global crisis. This is the problem with writing about still unfolding events – it’s easy to look out of date.

Sridhar is referring to what might happen if it is ever discovered that China knows much more about the origins of the pandemic than it has so far been willing to let on. How will the rest of the world react?

If the Chinese regime’s foreknowledge of the virus remains uncertain, it’s clear that the only chance to prevent the international spread was in its very early stages. That’s when China was at first concerned to suppress news of the outbreak and afterwards content to allow the virus to be exported while busily stamping it out at home.

Sridhar does not mince her words about China’s initial inaction and subsequent indifference to the global spread, nor does she dismiss the possibility that it was a laboratory leak that introduced Sars-CoV-2 to humanity. Still, even if China had acted swiftly and responsibly as soon as evidence emerged of a lethal virus in Wuhan, there is no guarantee that it could have contained it within China’s borders.

In a sense, then, the book’s title is a misleading one. Given the nature of the virus – able to be passed on by the asymptomatic – once it was in public circulation, a pandemic was probably unpreventable.

The question then becomes whether its effects, particularly the number of deaths, could have been reduced (last week, the World Health Organization estimated that the Covid death toll worldwide was nearly 15 million). Of this there seems little doubt and none in Sridhar’s mind. She looks at how different nations around the globe responded to the virus and seeks to establish the lessons of good and bad practice.

In short, the UK and the US, the two nations that were thought to be the best prepared to combat a pandemic, were guilty of complacency and blinkered strategies. This is not a new accusation, having been argued in depth and repeatedly by any number of experts and authors. Sridhar doesn’t add any groundbreaking revelations to what is a strong case.

The medical establishments in both countries leaned towards a “herd immunity” approach because they assumed that no vaccination would be available for several years at the earliest, if at all. It wasn’t an unreasonable assumption, given that there had never been a successful vaccination for any coronavirus and in any case vaccinations usually take about a decade to go from the lab to the public.

As it turned out, both the UK and the US managed to produce vaccinations for Covid-19 in record times. But it’s obvious that in the period between outbreak and the arrival of the vaccines some nations did much better than others in inhibiting the virus and limiting deaths.

Among those Sridhar praises are Senegal, Greece and South Korea. In terms of technological development and population size, South Korea is the closest to the UK, yet the British government and medical authorities appeared to think there was little that could be learned from east Asia. In this, as former health secretary Jeremy Hunt has argued, they were very much mistaken.

Perhaps the main reason that South Korea was able to limit both lockdowns and deaths is that its test-and-trace system was, in pronounced contrast to our own, highly effective. However, this did involve an incursion into personal privacy that was unlikely to be accepted in this country. Koreans’ movements were so finely and publicly tracked that secret love affairs and even hidden sexualities were brought to light.

Another reason for South Korea’s success, at least as far as Sridhar is concerned, was the widespread use of face masks. The scientific theories behind the virus’s transmission remain contested, but there does appear to be a broad correlation between the wearing of masks and reducing its spread.

The UK was not alone in coming slowly, and often half-heartedly, to mask-wearing. The WHO’s advice was at first that there was no evidence to support face masks. It also argued against the need for international travel restrictions. Sridhar believes that this was a progressive stance but nonetheless a wrong one. In the UK’s case, though, she sees only ideological intransigence.

“It was ironic,” she writes, “that a government that ran for election on the promise of ‘taking back control of our borders’ was so reluctant to implement border measures when they were actually necessary – in a pandemic.”

Sridhar is good on pulling together disparate information and data from across the globe, although she never quite shapes it into a compelling narrative. Instead, it’s a thoughtful overall look at what happened in the world in 2020 and 2021. There are many lessons to be learned and Sridhar emphasises the fact that we need to think on a global level about how to react swiftly to local outbreaks – always erring on the side of caution because the alternative, as we’ve learned, can be catastrophic.

To ready ourselves for the next viral challenge, it would help if there were a wholesale public rejection of conspiracy theories and the embracing of science. My favourite story from this book concerns Marc Van Ranst, a professor of virology and adviser to the Belgium government. For his work combatting the virus, he was threatened by a Belgian air force officer who went rogue with a submachine gun and four anti-tank missile launchers. The leader of a Dutch anti-lockdown/anti-vaxxer group, who happened to be a dance teacher, then suggested that Van Ranst had earned the death threat.

“When there’s a salsa pandemic,” Van Ranst tweeted in reply, “I’ll listen to you with great pleasure. But at this moment, I don’t give a flying fuck what you have to say and nobody in the Netherlands should either.”

Three cheers to that.