Spillover is the best background book around on Covid-19, even if that term does not appear in it. Quammen writes about the ‘Next Big One’, which we are in the middle of.
Spillover: animal interactions and the next human pandemic, was published in 2012 and warned about coronaviruses (‘serious threat to human health’) and for H5N1 flu viruses (‘a potential disaster’). But as the SARS outbreak 10 years ago wasn’t that bad in Europe, we just continued on our merry way in safe Europe, believing that we would not be touched by strange viruses that emerged from exotic live animals in dirty markets.
SARS was nice enough to first make people sick and only then transmit viruses through coughing and vomiting. This allowed people to be identified and isolated when they first became infectious. But the flu and other illnesses are often contagious before the illness is noticeable. Quammen writes: ‘If SARS had presented the harmful pattern of presymptomatic infection, its outbreak in 2003 would not have been the schoolbook example of a combination of lucky coincidence and effective measures against an outbreak. The entire story would then have been a lot bleaker’. This accurately describes our current situation and it is likely that this is the reason that the book is being published again. It appeared seven years too early.
Three-quarters of new diseases is zoonotic
Zoonosis, a disease which can be transmitted to humans from animals, is a word taken from the future that is expected to be used many times in the 21st century, says Quammen. Ebola is a zoonosis. As is bubonic plague, the Spanish flu, Lyme’s disease, malaria, Q fever, rabies, AIDS and many more. Three-quarters of emerging and re-emerging pathogens are zoonotic, writes Quammen.
People are part of nature so they share viruses with the animals around them. But the incidence of strange life threatening viruses is escalating. Quammen dates the start of the zoonotic era to the early 1960s. People travelled back from other continents and suddenly presented unknown symptoms. Why? According to Quammen, the rise of new illnesses from the animal kingdom is caused by two converging crises: ecological (climate change, deforestation, over population, monoculture), and shortages of medical services leading to medical crises in low-income countries. Cheap air travel also helps them spread.
This makes the book highly topical. On top of that, the breadth of the book is enormous. Quammen takes the reader around the world to shady restaurants, huge nurseries and wet markets in China. He also goes hunting for chimpanzee urine in Africa, and bats in China. You can see that Quammen writes a lot for the National Geographic magazine. His writing is readable, in his fictional works too, and he can immerse you in the Congo at the beginning of the 20th century where poverty, colonialism, prostitution and enthusiastic vaccination programmes helped spread AIDS decades before it was noticed. The ‘NRC Handelsblad’ newspaper calls his book ‘a masterpiece and a hugely exciting book’. And it is not exaggerating.
David Quammen, Spillover - Animal Infections and the Next Human Pandemic, W.W. Norton 2013, 592 pages, EUR 24.