Michael Lewis’s new book “The Premonition” attempts to answer the question: How could a nation that considered itself the best prepared in the world for handling pandemics so badly fumble its response to COVID-19?

His answer is as unsettling as it is inevitable; it goes all the way back to when Jimmy Carter and Ronald Reagan politicized the Centers for Disease Control. 

Lewis did not reach that conclusion easily or quickly. 

Most of his 304 pages are devoted to stories about unlikely heroes whose unsuccessful efforts included social distancing and mask-wearing, protocols that had helped in earlier crises. 

 

There were plenty of examples to learn from, starting with the 1918 Flu Pandemic that claimed 50 millions lives worldwide, including 675,000 in the United States.

Particularly instructive were the ways two U.S. cities handled the 1918 crisis. “The death rate in St. Louis was half that of Philadelphia because St. Louis leaders” implemented social distancing, Lewis wrote. More recently, U.S. officials succeeded with targeted efforts aimed at controlling outbreaks of swine flu, bird flu and SARS.

 

But there were always mistakes and miscues, and it was one such miscue that resulted in a significant change in the leadership of the CDC. From the agency’s founding in 1946 until 1983, its director was a civil service employee. Like the head of the FBI, tenure was not affected when a Republican president replaced a Democrat, or vice versa. 

But that changed, and it began after “a handful of soldiers’’ at Fort Dix, NJ, became ill in March 1976 and one died. “The CDC gathered samples and found they’d been infected by a new strain of swine flu that appeared to be related to the virus that had caused the 1918 pandemic,” Lewis wrote.

At least 500 soldiers were infected. “The severity of the disease was an open question, but it felt to the experts a lot like the one back in 1918.”

CDC director David Sencer approved a plan to create a vaccine and use it as quickly as possible. Vaccinations began in October and by mid-December, 43 million Americans had received it. 

Then, problems began. The vaccine was blamed for three deaths and illness in 54 people, and on Dec. 16 vaccinations were suspended. 

“The pandemic never came,” Lewis wrote, but in 1977, Jimmy Carter replaced Gerald Ford as president, and Joseph Califano, Carter’s new secretary of Health, Education and Welfare, fired Sencer.

A widely publicized follow-up report justified firing Sencer, alleging that his leadership was unstable –  “a hero in his own mind” – and that he had overstepped his authority. 

But, Lewis noted, Sencer’s critics “never satisfyingly answered the question of motive: Why a man who had devoted his life to public health misled the public about a health threat.” And they ignored the fact that Sencer had wide support among peers for making tough decisions in uncertain times.

The real lesson was that cynicism and distrust of government, created by the Vietnam War and Watergate scandal, had imposed new constraints on public officials.

“Changes in the media and society had led to changes in the way technical decisions were perceived, and so people with mere technical expertise could no longer make decisions without paying more attention to how they might be made to appear to a cynical public after the fact,” Lewis explained. 

A breaking point occurred in 1983 when Sencer’s successor resigned after Reagan appointees refused to let the CDC publicize a study showing a potentially fatal connection – Reyes syndrome – could occur in children who took aspirin to reduce fever caused by measles or flu.

That’s when “the White House converted the position of CDC director from career civil servant to presidential appointee.” 

The change allowed Trump National Security Advisor John Bolten in April 2018 to fire and demote members of a biological threats team because Bolton believed “the only serious threats to the American way of life came from other nation-states,” Lewis wrote.

And that, among other things, made it difficult for U.S. officials to respond when the COVID-19 pandemic arrived.