Plague: A New Thriller of the Coming Pandemic

The best-selling author of Outbreak has an exclusive tale for FP about a catastrophe of global proportions. And by the way, it's not fiction.

BY ROBIN COOK | NOVEMBER/DECEMBER 2009

Sometimes fiction can do more to change public opinion than nonfiction. It took Upton Sinclair's 1906 novel, The Jungle, to awaken the public to the dangers of sausage and the meat-packing industry in general. Another example, if I can be so presumptuous, is my 1977 novel Coma, which opened readers' eyes to the dubious side of the medical profession after years of misleadingly warm and fuzzy treatment of doctors and hospitals in novels, movies, and TV series. Today, there is a crying need for a new such socially conscious novel to shake up the complacent public about the high risk of an imminent, serious pandemic. And I don't mean the much-publicized swine flu. While the world media has obsessed, and rightfully so, about this fast-spreading illness, I'm worried about the next crisis, something much deadlier and much more catastrophic, indeed the kind of crisis most people wrongly believe could not happen in this day and age. If I were the author, this urgently needed novel would have to be called Plague.

Related

What a Pest

Why the Black Death stil won't die.

By Emily Anthes

Everyone has heard of plague and knows it means a sudden outbreak of a virulent disease. But it also has a very common, very specific association in the public mind: It's synonymous with the Black Death, the scourge caused by the bacterium Yersinia pestis that swept through Europe (as well as much of the rest of the world) from 1348 to 1350. Viewing this monumental and even Malthusian event from the vantage point of nearly seven centuries later, one cringes at having to contemplate the horror, the excruciating pain, and the terror its victims had to suffer. Knowing the pain involved with a tiny boil, it is almost impossible to imagine what it was like being deathly ill with most of one's lymph nodes swelling to the point of becoming visible, blackened lumps with their interiors necrotizing and liquefying -- and all of that happening without analgesics and certainly without antibiotics. If David Letterman presented a top-10 list of the worst possible ways to leave this world, dying of the plague in the 14th century would have to be at the top.

And the horror of the Black Death went far beyond individual physical pain. Given the speed with which the illness spread through cities, it must have caused ultimate anxiety and panic as the wildfire disease left rotting, infective corpses, oozing putrefaction, piled in the streets. Urban society was unable to cope and, in many places, essentially collapsed due to the number of victims (some cities lost 90 percent of their residents). Adding to the chaos, war between two of the era's more significant powers -- England and France -- raged fitfully on and off after 1337. Commerce stagnated, especially in regard to food, causing famine. And perhaps cruelest of all, paroxysms of gruesome mass murders erupted as minorities were scapegoated. All in all, the Black Death had to have been hell on Earth, especially because no one -- not the doctors, not the priests, and not the scientists of the age -- had even the slightest idea of what was causing the calamity, how it was spread, or how it could be treated.

Photo Illustration by Wind-Up Digital for FP

 

Robin Cook, an ophthalmologist and surgeon, is the author of 29 novels, including, most recently, Intervention.

JIMMYBOBBY

1:37 AM ET

October 19, 2009

Mother Nature will have her day

Populations of any living thing that have become too large for Gaia to sustain have routinely peaked, then fallen prey to disease as a way to reestablish balance in the biosphere. With all our technology, we still may be unable to fight the equalizing forces of nature. There are too many people and we're doing too much to upset the elegant design of nature. It may just be time for a plague to bring life on Earth back into equilibrium.

 

JACOB BLUES

10:20 AM ET

October 19, 2009

Mr. Cook should turn in his MD

What a sleazy way to try to sell some novels.

The medical oath of "first, do no harm" falls flat as the author tries to build up panic and nerves, in hopes of selling his latest batch of fiction.

And his best advice? Build up a vaccination system.

Reality is, there is a vaccination system in place for the flu that pumps out millions of doses on an annual basis given that the flu is typically a seasonal threat.

The reality is, these vaccine's need time to be tested for efficacy and protection prior to their production and distribution. Fact is, if the H1N1 virus had occured earlier in the year, it would have been part of the normal flu vaccine rather than requiring a seperate dose this year.

Given the time constraints, what would the author have government's do? Add in back up production investments? Shortcut the testing time, or just distribute vaccine's with unknown efficacy and/or potentially harmful side effects?

Sowing panic and running off to one's ski chalet to write their next novel doesn't seem like a good way of offering a solution.

Next time Dr. Cook should act like a physician rather than writing about one.

 

JPEARSON7

11:11 AM ET

October 19, 2009

Plague

There is a convincing argument that the 'black plague' was actually anthrax - as it broke out across all of Europe almost at the same time and in many rural areas with little contact with the sea ports.

 

AFUNK

11:50 AM ET

October 19, 2009

I think someone already wrote this book

http://en.wikipedia.org/wiki/The_Stand

 

BFFOLEY

12:38 PM ET

October 19, 2009

Wow

The Spanish Flu was as serious as it was because it came down hard on a war stricken Europe. The Plague was serious (and still is in some areas of the world) because at the time most of Europe were a bunch of peasants sleeping on flea infested beds.

Meanwhile, in this day and age most Americans live close to hospitals, wash their hands with anti-bacterial soap several times a day, and jump through hoops (i.e. wearing face masks, not leaving the house, buying Cipro so the "terrists" don't get them) whenever the media spins them up about the virus of the year. H1N1 will pass just like Avian Flu, SARS, West Nile Virus, EEE, Anthrax via USPS, etc etc. It'll kill a bunch of people in rural areas in around the world and kill a few dozen people with comorbid conditions here in the US, but it'll blow over.

But I suppose those facts don't help Mr Cook sell books via an advertisement disguised as an article, huh?

 

LEMONGRASS

4:59 PM ET

October 19, 2009

Did you read the article?

Avian flu HASN'T passed. It's still out there spreading. But its low transmission rate means it spreads very slowly, and because the American media is addicted to novelty, no one wants to hear about it anymore. Don't let that fool you into thinking it's not around. It is, and it's still killing people. Just not Americans.

 

EXOTTOYUHR

1:08 PM ET

October 19, 2009

This is a real risk.

This is hardly something to be ridiculed. A 60% kill rate plus high transmissibility really will be within spitting distance of the end of the world, should it come to pass, and there really is a chance, as pointed out in the last page of this article. We have come to imagine that anything sufficiently dramatic, sufficiently like something in a novel, can't possibly happen in the industrial, real world, but I would have hoped that September 11th and the Russian-Georgian War would have disabused us of that particular fantasy. Just because it doesn't sound like something possible, doesn't mean that it isn't; pretending there's no risk of pandemic flu doesn't mean it will go away.

 

EXOTTOYUHR

1:10 PM ET

October 19, 2009

Another thing on the dramatic not happening.

Now that I think about it, the best illustration of how things more dramatic than we expect can happen would be the career of Hitler. Do you think that a believer in modernity and progress, someone like H.G. Wells or Herbert Spencer, would have believed you had you told him what was going to happen in the world well after his career?

 

LEMONGRASS

4:53 PM ET

October 19, 2009

Yep

Actually, pretending there is no risk of a pandemic flu is pretty much a guarantee that it WILL happen. Nothing helps a catastrophe along like people sticking their heads in the sand.

 

JMON

2:02 PM ET

October 19, 2009

might wanna find a different title

There was already a novel called Plague. And it would be a great disservice to that great work and the accomplishments of Camus to call a cheap fiction thriller the same thing.

 

LEMONGRASS

3:25 PM ET

October 19, 2009

Write the book!

I would definitely read it. Sounds like a page-turner, all right, and the information would come in mighty handy. But there's just one problem with the solution proposed (strengthening the process of vaccine production).

How are you going to get people to take the vaccine? Remember, there's a plague of stupidity already going around regarding this subject. A growing percentage of our population are listening to Hollywood know-nothings like Jenny McCarthy who are going around spouting anti-science nonsense about vaccination. A brilliant vaccine, no matter how thoroughly tested and remarkably active, will be worth nothing if people won't take it.

 

S8NSUX

5:29 PM ET

November 3, 2009

vacccines and the flu

Lemongrass, one thing you apparently missed in the "article" is the recombinant nature of the bug! One mutation and your precious vaccine is worthless. Then you end up with G-B syndrome AND the flu. NO THANKS! I'll take my chances in my cabin!

 

ELLIOTT6184

4:16 PM ET

October 19, 2009

Not to be flippant

But this scenario is remarkably similar to World War Z, and not in a bad way. The "zombies" in that novel even start in China. The ending has no clean resolution, just survival and adjustment to a new world.

 

ARGUSRUN

4:41 PM ET

October 19, 2009

Disgusting self promotion

Really? You're giving space to a guy who compares The Jungle to a work of fiction in which "bodies are suspended from the ceiling by wires in rooms walled by glass and are moved from room to room with little human involvement. This is where the "patients" are kept until a call for an organ comes in. Then the right donor is prepared, and the organ of choice is removed surgically (and without consent) and sold on the human organ market." (wikipedia)

His novels may be entertaining, but that initial conceit made me stop reading.

This alone shows the intent to be self promotion rather than public education.

 

LEMONGRASS

4:56 PM ET

October 19, 2009

Ah yes

The eternal sniffing of the Ivory Tower fan. How many people do you know who actually read Camus as opposed to Cook? Given a choice, I'd much rather have a popular book introduce people to the ideas proposed here and a possible solution, than be content with a tome that few people read anymore. You may sneer, but that popular book would get READ, and that's the main thing. Perfect is the enemy of better, sir.

 

ARGUSRUN

9:00 AM ET

October 20, 2009

I've never read Camus...

but comparing Coma to The Jungle is a level of conceit that immediately calls the author's intent into question. I like Robin Cook's novels. They are entertaining. But trying to bill his novels as a desperately needed public service aimed at reforming the medical community is like Dean Koontz expecting Sole Survivor to spur Congress into investigating those pesky murderous telepathic children being bred.

Mr. Cook could have dropped his novels in with a bit more finesse or humility and I would not have objected. Mentioning them as evidence that he has long been interested in the medical industry and public health concerns would have been enough, but it was the pointless desire to inflate his novels importance to literary and American history that turned me off and make this whole exercise questionable.

 

LEMONGRASS

8:05 PM ET

October 20, 2009

Uh, dude

Camus didn't write "The Jungle". Sinclair Lewis wrote that. Albert Camus wrote "The Plague". Perhaps before getting so high-handed you should get your facts straight.

And nobody here, including Mr. Cook, is pretending that he writes his novels to be a noble educator. His books are entertaining tales rooted in medical fact. He even says so in the article. People get informed as a by-product of reading those novels. So again, perhaps you should take a little time to make sure you understand what people are actually saying before you get up on that horse.

 

PHILIP_TRAUM

6:57 PM ET

October 19, 2009

FUD at its finest - FP at its worst

At what point did FP become a grandstand for purveyors of hysteria and half-baked ideas? Each one of these increasingly common articles makes me feel like picking up a phone and canceling my subscription. If you can't provide news worth reading then you may as well print the number for the Economist's subscription office.

As for the article, the author does presume far too much about his own ability. Looking over his works seems to reveal nothing more than mediocre medically themed hysteria novels, and his laughable assertion that making the book a [sic*] "super-best-seller" would inexplicably save the world sounds suspiciously like the argument a con-artist would use.

I can accept the fact that it's at least possible for something like this to occur. It's about as likely as a dozen other fairly legitimate apocalyptic scenarios, all of which are "on the verge" of occurring according to who you listen to, none of which are as likely as simply dying in a car crash or from some other mundane cause, but those don't make good fiction. Continue wearing tin-foil hats inside your gas mask laden ski-lodge, I'll go on enjoying life before ultimately being struck and killed by an ironic, flu-ridden comet.

The truth is that pandemics don't happen often because it requires a huge number of complicated factors to all work in the virus' favor. They are similarly hard to stop because they represent that exceptional case. No amount of putrescent paperbacks are going to change that, and not one sentence of this article belonged on this site. To FP: Either up the quality of your content or lower the quality of your readers, you can't have it both ways.

*Not because it was grammatically incorrect, because it was infantile and I'd hate to be associated with it.

 

AZRAEL

12:09 AM ET

October 20, 2009

I concur.

I just got done railing on the editors for that Think Again article about God also on the front page right now, and then I run into this! Thankfully, you've saved me the trouble of once again expressing my discontent with this site's recent content.
Seriously, FP, are you even trying to stay relevant anymore?

 

STACEYD

10:35 PM ET

October 19, 2009

The science says it CAN happen

Good grief! Why would a successful novelist need to promote his next book? Does he really need the money after having so many runaway bestsellers? And some that were turned into movies, to boot?

Do any of you have M.D. after your names? Do you understand how evolution works on the cellular level? It can happen, it most likely will happen (the best we can hope for is that it's localized in one particular region of the world) and just because you can't imagine it, will not keep it from happening.

So many crises have occurred in the past 100 years that no one thought could happen - from WWl through the present day recession brought on by the collapse of the financial markets.

China has polluted its water and air, poisoned countless people all over the world with counterfeit products and use of toxic metals in their products, killed thousands (probably hundreds of thousands) of family pets with poisoned pet food and has endangered their own people with tainted milk, food and medicines.

China aspires to take its place at the table of modern nations, but with 70 percent of its population leading marginal lives in the rural backcountry or toiling for meager wages in factories with little or unenforced or no regulations governing worker safety and rampant corruption is a recipe for disaster: either in the form of the worst pandemic to be seen in a over a hundred years or worse, the systemic annihilation of a major portion of the peasant population through civil war.

 

ASGOLD25

9:30 AM ET

October 20, 2009

Don't compare a potential

Don't compare a potential outbreak to conflict or economic crises. Those events are far more difficult to predict, with the former not occurring in much, if any kind of a cyclical manner. Doing so oversimplifies the issue.

Yes, we all know that bacteria and viruses are continually evolving, and the likelihood of a deadly strain taking form at some point or another in the near future is high. There is, however, reason not to overreact. For starters, modern hygiene and sanitation techniques in the industrialized nations of the world will severely constrict the ability of any virus or bacteria to spread rapidly. Additionally, modern medicine is sophisticated enough to first stem the spread of an epidemic and later develop medicines to either cure it or reduce its deadliness. When the next outbreak does come along, it will most likely have the greatest impact in the third world, particularly in tropical or sub-tropical climates where severe overpopulation and poor sanitation is the norm. The Doomsday scenario that so many people seem to envision is highly unlikely.

 

STACEYD

8:54 PM ET

October 20, 2009

I'm a realist, not an alarmist

"For starters, modern hygiene and sanitation techniques in the industrialized nations of the world will severely constrict the ability of any virus or bacteria to spread rapidly."

What part did you miss in the article - the part about the filthy conditions in China's backwater of one billion people (70% of the total pop. of what is considered an industrialized nation) or the part about the mutation of the virus...

"either the H5N1 gives its virulence to H1N1, or H1N1 gives its transmissibility to H5N1. Either way, a genetically shifted subspecies emerges, and the entire world faces something similar to what Europe faced in 1346 when the first Y. pestis-infected rat jumped ship in Crimea."

The world is no longer flat, as perceived in the middle ages and millions of people on trains, planes, ships and autos travel the globe daily. There is no way, short of enveloping the planet in a sterile bubble or moving the world's population to Antarctica and living outdoors, of preventing a highly virulent, fast moving disease from overwhelming hospitals and healthcare personnel on six continents to the point that nobody can receive treatment. Just as Hurricane Katrina overwhelmed emergency efforts in an entire region a mutant variant of these viruses is as much a force of Mother Nature as any Category 5 hurricane, if not, more so. Just because it hasn't happened yet doesn't mean it can't.

 

PHILIP_TRAUM

9:52 PM ET

October 20, 2009

Potential != Fact

You seem to be debating against an absolutist argument that no one thusfar has actually offered. Statistically you are correct, it's possible for something like this to happen, and given a long enough timeframe it would occur (as well as a number of other doomsday scenarios). The problem is that there is no way of determining the actual probability of such an event other than simply saying p(x) > 0.

That's the root problem of your argument. You seem to suggest by tone if not explicitly that just because something can happen means it automatically will happen, and it will do so in the foreseeable future. That's just not true, no human or computer in the world could gather and process the information needed to make anything more than a random guess at it's time of occurrence or its effects. This is just one of many cataclysm theories floating around and for my part I'll need a lot more convincing than some shamelessly self-promoting author looking to pad his pocketbook by inciting hysteria.

 

LEMONGRASS

1:32 AM ET

October 21, 2009

"Inciting hysteria"?

Aren't you giving a little too much credit to the Foreign Policy website? How many people do you think have read this article, anyway? The problem isn't that anyone is inciting hysteria. Quite the reverse. It's practically impossible to incite people to "hysteria" these days. We've grown far too complacent to avert anything of this kind anymore. The avian flu has a kill rate of 60%. Where's the hysteria over that disease, which is still killing people? As soon as the news media gets tired of reporting on the swine flu, any possibility of "hysteria" will fade away, as the population will automatically assume it's over.

If anything, there's too LITTLE of what you call "hysteria", and what I would call plain old attention, regarding these matters. If it isn't on the news, people don't care. And even then, unless it actually hits them, they assume it's got nothing to do with them. THAT is how the next plague will spread - through inattention and apathy, just like AIDS. Remember that one? That killed and is still killing millions?

 

STACEYD

3:01 PM ET

October 22, 2009

Hysteria Vs. Awareness

Lemongrass has a good point but I prefer to call it awareness. Awareness, unlike hysteria, takes the time to consider all the facts at hand and not jump to conclusions that the end of the world is imminent.

Those who are aware and knowledgeable about the conditions that can contribute to a crisis will be the ones who are more prepared to face the situation and protect themselves and their loved ones, rather than yammer on that this was not supposed to happen or the odds were slim to none.

 

PHILIP_TRAUM

11:12 PM ET

October 29, 2009

Everything I needed to know I learned from fiction...

Inciting hysteria was not a terrific choice of words I would agree, but the point remains that neither the article or the book screams "well reasoned and thoughtful". For starters, the book is fiction. I understand of course that the author is a doctor and just because it's fiction doesn't mean it doesn't contain facts. But containing facts is far from actually being factual, and reality rarely makes good fiction. If you want to argue for a rational and reasoned approach to the problem of disease and epidemics I won't resist, but don't do it here. Arguing that a book like this somehow gives people relevant information to help them prepare is like saying The Day After Tomorrow somehow gives relevant advice on climate change. Finally, I would point out that these things are not a zero sum game, all the time and money we spend "preparing" out of panic for a long shot is time and money we don't spend on boring problems that can be more significant.

 

ADAMH

11:45 PM ET

October 22, 2009

Unexpected Expenses

Unexpected expenses, besides alliteration, are a royal pain in the neck. You never know what's coming your way, and when they do, it can make you shake like a long tailed cat in a room full of rocking chairs. There are credit cards, bank loans, but cards are a lot of hassle and banks have long waiting periods and credit checks. You can also get a payday loan, or cash advance – same difference. To offset unexpected expenses, you can get short term loans, small loans that you repay quickly – just as other financial tools; they must be repaid, and are perfectly fine if used responsibly.

 

UGGS

8:36 PM ET

October 26, 2009

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DANDHBEACH

3:19 AM ET

October 27, 2009

Another story

Another story about catastrophes..i want to read it..how much does it cost?

How about some end of the world books..?Dry Eye

 

HANK SMALL

1:19 PM ET

November 3, 2009

Crisis and fear

"When written in Chinese, the word 'crisis' is composed of two characters--one represents danger, and the other represents opportunity."
John Fitzgerald Kennedy

Someone is trying to profit from fear.