Science

Preventable by Devi Sridhar review – a resolutely global view of Covid


Professor Nabila Sadiq was only 38 when she died of Covid-19. Unable to find a hospital bed in her native India, which had been overwhelmed by the virulent new Delta variant, her heart-rending Twitter messages pleading for help were picked up around the world. The story clearly hit home with the Scottish public health expert Professor Devi Sridhar, who is around the age Sadiq was and whose family are of Indian heritage. As she writes poignantly in her new book: “She would have lived had she been in Scotland, like me”.

Accidents of geography are arguably a key theme of Sridhar’s book, an ambitiously wide-ranging study of a global pandemic with the emphasis firmly on the global. As she points out, individuals’ fates were too often determined by where they happened to have been born: living through the pandemic in Vietnam or Kerala was not like living through it in Britain. The refreshing twist in her tale, however, is that often it was countries from whom we are not used to taking public health lessons that got it right while a complacent west messed up.

Most people have heard of New Zealand’s zero-Covid experiment or Swedish resistance to lockdowns. But what about Senegal in west Africa, and the invaluable lessons it learned from an outbreak of Ebola? Should we have paid more attention to South Korea, an early adopter of living with Covid, which embraced social distancing and masks but sought to keep schools open and avoid full lockdown with a formidable (if very invasive) test-and-trace system? And before Delta, the Indian state of Kerala was arguably a model of coping with Covid in an impoverished population. Yet British experts, she writes, were “so used to telling poorer countries how to do global health that they completely forgot humility and to listen to what experts in those poorer countries were saying or doing”.

Sridhar will be a trusted guide to many Guardian readers thanks to her regular pandemic columns, which so many of us faithfully consulted to work out how worried we should be whenever the virus took some new turn. After living under the shadow of the virus for so long, I thought I’d be happy never to read the word “Covid” again, but of all the accounts snapped up by publishers in lockdown hers was the one I was curious about.

It is not a rip-roaring read, however. If you want something pacy and full of horror stories about Downing Street’s dysfunctional response to Covid then this isn’t the one (try Jeremy Farrar and Anjana Ahuja’s Spike instead). Sridhar’s account is heavy on the detail that scientists love but lay readers may occasionally find exhausting, and it could have done with a stronger narrative thread from which to hang its fascinating tales from around the globe.

Since Sridhar advised Scotland’s first minister, Nicola Sturgeon, to whom she remains close, it would also have been good to explore Scotland’s experiment with trying to eliminate the virus in greater depth. She notes that in the summer of 2020 Scotland actually came within a whisker of getting cases down to zero, only to be foiled by a fresh wave imported by tourists. Sridhar hints that an independent Scotland – which would have been able to close its own borders and control its own furlough schemes, powers currently reserved for Westminster – might have enjoyed different outcomes. But given the political reality in 2020, was zero Covid ever a realistic aim if England wasn’t on board? It would have been fascinating to unpack all this in more detail.

The book’s strength, however, is its resolutely unparochial and distinctively millennial’s eye view of the pandemic, keenly alert to all the inequalities and asymmetries of power exposed. In the end, wealth sadly became “the best shielding strategy not only from Covid-19 but from the response to it as well”, she writes, with rich countries gobbling up vaccine stocks at the expense of poor ones, and rich individuals weathering lockdown more comfortably than poor ones. Lessons must be learned, she argues, for future pandemics.

But there is another lesson to be drawn from the first wave, when the west could arguably have saved itself much heartache by recognising that it wasn’t always money that talked. For Asian countries drawing on experience of previous coronaviruses, or African countries with fragile healthcare systems who recognised they couldn’t afford to be complacent, in the early days “competence not wealth” mattered. The moral of the story, perhaps, is never to assume the two automatically go together.

Preventable: How a Pandemic Changed the World & How to Stop the Next One by Devi Sridhar is published by Viking (£20). To support the Guardian and Observer, order your copy at guardianbookshop.com. Delivery charges may apply.



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