The COVID-19 Catastrophe: What's Gone Wrong and How to Stop It Happening Again

As a Professor of Microbiology, with elderly parents and children it was with considerable personal interest that I read this book. As Editor-in-Chief of The Lancet one should listen and reflect on Richard Horton's opinions which appear haunted by the frightening messages he received from front line health care workers in the UK over the lack of preparedness and PPE, followed by their avoidable deaths.The book has 7 chapters, and is short at 127 pages plus references which have been kept to primarily peer reviewed papers. I took me just over one evening to read. Chapter 1 ‘From Wuhan to the World’ sets the scene with a timeline of events from 30th December 2019, including the WeChat message of Li Wenliang, through to WHO notification on 1st January, the WHO declaration of Public Health Emergency of International Concern (PHEIC) on 30th January, and the predictive epidemiology work of Gabriel Leung’s group in Hong Kong. The shadows of SARs, Ebola and Zika are very evident in the decision making by the numerous political and health groups, and the path that Tedros Ghebreyesus WHO’s Director General has tried to take.The book progresses with coverage of the various lockdown approaches adopted by various governments and their affect to the date of the book. Richard defends China’s approach against many of the criticisms, but not all. He is also highly critical of Donald Trump’s approach within the US and in particular his intended withdrawal of funding from WHO, which Richard describes as ‘a crime against humanity’. As for the UK, the PM is criticised and U-turns listed. But so too are parts of the UK scientific community criticised. Those named include the medical Royal Colleges, the Academy of Medical Sciences, the British Medical Association, Public Health England, the Faculty of Public Health, King’s Fund and Nuffield Trust. Why? Because of their deaf ears to the WHO’s declared PHEIC. The SAGE committee is also criticised for their initial anonymity, inclusion of BREXIT advisor Dominic Cummings and the lack of experts in respiratory and intensive care medicine. SAGE members are regarded as being too dependent upon Government funding to rock the boat. The final chapter ‘Towards the Next Pandemic’ emphasises the need for change, the recognition of inequality and lack of adequate funding for social care. Unfortunately at a time of ‘One Health’ we need the recognition of ‘One World’ in order to prepare for the next pandemic, instead we have an unhealthy polarisation of countries.As given before the book is short and aspects I would have liked to have been expanded upon include (1) Why WHO’s advice on ‘test, test, test’ was not initially undertaken in the UK (2) The accuracy of early test kits used in China, Japan and USA (3) The story of Diamond Princess (and other cruise ships) and the studies which have been done on the transfer of the virus via staff, food, and air.Due to space constraints I can only give a taster of the book, but I hope it has encouraged you to read it for yourself and reflect on what needs to change if we are to survive the next potential pandemic.

This book is short, very well written, and I'm glad I read it. So far so good. According to the author, the Covid-19 challenge has been flunked by just about everyone in a position of responsibility, though he doesn't seem to include himself on the list despite appearing to have an ideal bully pulpit from which he could have screamed "take cover" in the six lost weeks of February and early March (a couple of Tweets and some straight-laced article titles in the Lancet don't cut it, at least to me). Nonetheless, I ended the book with a higher opinion of the author than I started it with, I did learn some new and interesting things along the way, and it didn't take long.

This is an extraordinary piece of scholarship and writing. It is about COVID-19 but about much more than this. It is about science, politics, ethics, and the future of civilization. Like many people working in public health, I was concerned by Richard Horton's early criticisms of the UK government's and its advisors' handling of the crisis. Not because I thought he was wrong in substance but because I thought a more constructive tone would have been more helpful. I was wrong and he was right. The UK government, like that of the US and Brasil, has shown itself to be deaf to constructive criticism. Those of us who care deeply about the future of our society have to steadfastly oppose attempts to 'get back to normal' and we have to make Richard Horton's positive vision of what a post COVID-19 world could be like a reality.

If you know next to nothing about the Covid-19 pandemic - and first of all, which cave have you been hiding in? - then you may learn something from this book. But if you have been following developments, then you may end it, as I did, feeling not much the wiser.To be fair, Horton does land some messages which are worth considering. In his view the Chinese, however dreadful they may be politically, did a reasonable job and were fairly open about what was happening. He also argues that the World Health Organisation did a good job given very limited resources. He also believes the UK government and many of its scientists made a mess of it (big surprise to no one living in the UK), partly by preparing for an influenza pandemic (Covid-19 is very different) and partly by refusing to reach out to other countries and learn what was happening elsewhere, what to expect and what might help. British exceptionalism in the face of a virus which knows no borders.You will also learn that he is an angry man with a strong political agenda and you may find his tendency to rant rather tiresome after a while.But mainly you will read a lot of things you already know.

This is quite a short read and as such vastly overpriced. It didn’t really go into any detail and I never learned much more than I have done by following the news and reading newspapers. I was hoping due to the authors background he could have educated me more. At some point there will be some excellent books about COVID 19 and the failings of government, unfortunately this book isn’t it. For example in the UKs response I’d have liked to have read that SAGE said this, the government did that etc etc. It reads like a quite long essay or quite article, or perhaps a few edited together. With hindsight its probably too early (June 2020) to publish a comprehensive assessment of the failings. There are for example no interviews or insights from anyone, more the authors opinion. As one of the first books published on this subject it will probably be quite financially successful, I suspect that is why it has been published. To be honest I could have cut and pasted a load of newspaper articles and come up with something similar.