Book Review: Deadliest Enemy

I assigned two books as alternative reading for my Pandemic Book Club, for May. One of them was Deadliest Enemy. It was the one book that was holding my attention, for most of the month, but I kept sticking it on the back burner because there were always more books that I “had” to read and were taking me forever.

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Not that Deadliest Enemy, by Michael T. Osterholm and Mark Olshaker is a wonderfully written book. It’s written just well enough to keep you engaged and reading, as long as this sort of thing interests you. (All the policy stuff at the end is what finally challenged my attention.) But it’s a science book, so the lack of breathtaking passages isn’t surprising. What is this book about? What is the “deadliest enemy?” Killer germs. Infectious disease. Which comprises a few different things: antibiotic resistance, bioterror, pandemics, and endemic disease, mostly. Osterholm has been at the forefront of infectious disease for decades. Olshaker is an expert in writing books about the criminal mind. Olshaker uses stories of case studies, medical science, policy research, medical history, hard-hitting quotes, and a whole lot of experience and trial and error to unfurl the scroll of writing on the wall for the layman: we’re in a heap of trouble and it’s impossible to say when the ax will fall. (Whew, metaphors!)

One of my favorite things about the writing in Deadliest Enemy is Olshaker’s truly scientific attitude: he’s curious, he’s hopeful, he’s full of questions, he is unwilling to give maxims, and he is completely willing to learn from his mistakes and the mistakes of others, even if that means eating crow. He frequently tells us what lesson he learned from some crazy, amazing experience, like trying to figure out what AIDS was or saving his own child from a mosquito-born disease. He is also unapologetic about what he does believe based on his many years in the field and his intensive knowledge of epidemiology. For example, he is straight-forward about what vaccines have accomplished, how they work, and how they can save us in the future: the (mostly) good, the bad, and the (not so) ugly. Anti-vaxxers can either listen politely while the expert speaks, or they can chuck the book across the room.

Admittedly, this might be a book you don’t want to read, especially during a pandemic, especially if you are on the left and, as the experts are telling us now, more prone to worry and overcompensate. I find all this info fascinating, but there is definitely a fair dose of doomsday-and-not-much-I-can-do-about-it. I mean, sure I can refuse unnecessary antibiotics and submit to vaccines, but the real issues here can’t even be touched by one person, let alone one nation. These are global issues and take absolutely enormous efforts, forethinking, science, money, cooperation, etc. I feel like even Osterholm struggles with what the solutions might be, though he often points to much more government effort. Our votes count. Our philanthropy counts. Our awareness counts. But can it possibly make a difference? This is why people read this stuff and then build bunkers. Or, if you are a billionaire, start a world health fund aimed at one of these problems. Alas, I am not a billionaire. To the bunker, then!

I like knowing stuff, so I can just tuck all this knowledge away, live conscientiously, shoulder some guilt, and speak my mind, spend my dollars and vote when called upon. I did enjoy this book, for all the seriously scary things he mentions. I liked his celebration of the scientists and innovators who have made life—and death—more humane for millions and even billions. But yes, I see, we have also gotten ourselves into quite a few pickles as the human race, and we’re pretty divided and prone to act irrationally and selfishly. Of course, some of the interest in reading this book during the Covid Pandemic was noting how much he pre-read our mail, back in 2017 when it was published. He saw all this coming. And it is also worth noting that this pandemic is likely not the worst one in 2017’s near future.


“Once we knew what we were dealing with and how it was transmitted, we were unable to stop or warn off much of the behavior and habits that led to its spread. Evidence, knowledge, and logic aren’t always enough” (p20).

“…it also made me realize how easily data can be misinterpreted into flawed science and how important it is to get a number of perspectives on board. And it taught me to make sure you ask the right questions, lest you be led to the wrong answers” (p41).

“You don’t have to have all the answers to have the critical answer” (p47).

“There are more microbes in the human gut than there are cells in the entire body, and there are microbes virtually everywhere within us” (p60).

“The battle lines are well drawn: the microbes’ genetic simplicity and evolutionary swiftness against our intellect, creativity, and collective social and political will” (p63).

“It’s hard to overstate the impact of vaccines on our history and on our lives” (p80).

“So successful was the effort to curtail or eradicate the range of childhood diseases that the public started taking their absence for granted” (p84).

“What we really need is a game-changing influenza vaccine that will target the conserved—or unchanging—features of the influenza viruses…” (p91).

“But we can’t wait for an international consensus; the infectious bugs are now gaining on us at a breakneck speed” (p92).

“We keep coming back to the reality that what kills us, what hurts us, and what scares us are not one and the same” (p98).

“The possibility for a DURC research study using a potentially dangerous influenza virus should scare the hell out of everyone” (p122).

“…he calmly recalled his research and described the agents he had worked with: anthrax, brucellosis, glanders, Marburg, plague, Q fever, smallpox, and tularemia, among other toxic bugs. All of them had been bomb and missile ready. He said they had developed 2,000 strains of anthrax alone in an attempt to make it as deadly as possible” (p129).

“’Simply put, the Nation does not afford the biological threat the same level of attention as it does other threats: There is no centralized leader for biodefense. There is no comprehensive national strategic plan for biodefense. There is no all-inclusive dedicated budget for biodefense” (p140).

“’There is not a city in the U.S. with more than three isolation beds, other than New York. New York has eight’” (p156).

“I believe it was Winston Churchill who said, ‘It’s no use saying “We’re not doing our best.” You have got to succeed in doing what is necessary’” (p158).

“’We know that mutations or small genetic changes can dramatically affect the epidemic potential, and probably virulence…’” (p212).

“Zika and all the other Aedes-transmitted diseases are going to be a trench-warfare slog against the mosquito and the viruses it carries” (p214).

“Antibiotics are, in fact, a natural resource—or perhaps more accurately, a natural phenomenon—that can be cherished or squandered like any other gift of nature, such as clean and adequate supplies of water and air” (p217).

“What we are dealing with, to put it plainly, is a slow-motion worldwide pandemic. With each passing year, we lose a percentage of our antibiotic fire-power” (p218).

“…within ten to twenty years, we could well be moving into the postantibiotic era” (p220).

“’Tragedy of the Commons’ applies to scenarios where an individual acts to significantly benefit [himself], and as a consequence accepts as a tradeoff a small amount of overall harm to society at large” (p222).

“Like many drugs that treat serious conditions, they have side effects—in the CDC’s example, by possibly wiping out the ‘good’ and necessary bacteria in the gut” (p223).

“So far, the [antimicrobial] problems have far outpaced the solution” (p228).

“…if antibiotics are a societal trust—if my use affects your ability to use them, and then your use affects my grandkids’ ability to use them—why are we allowing people to choose?” (p242).

“…it’s all bird flu; there’s no such thing as a naturally occurring human influenza virus” (p256).

“As far as pandemic potential is concerned, the most dangerous place on earth are anywhere people, birds, and swine are crowded close together in large numbers” (p257).

“[Pandemic influenza] has happened at least thirty times since the sixteenth century, and our modern world presents all the ingredients for an imminent return” (p257).

“…everything we use today is connected in some critical aspect to a production line far distant from our homes” (p262).

“One hundred percent of [the critical] drugs were generic; all were manufactured primarily or exclusively overseas, mostly in India and China; there were no significant stockpiles, and the supply chains were long and extremely vulnerable” (p264).

“’We need to realize right now that we do not have an adequate vaccine for influenza’” (p288, Tony Fauci).

“There are also several new studies that suggest it is actually better not to have the vaccination each year, that such a practice may actually cut down on antibody response” (p289).


PS. One question that wasn’t answered: does antimicrobial products (hand sanitizer, antibacterial cleaners and soaps) contribute to antibiotic resistance, in what ways, and how much? Otherwise, he answered all my questions and told me a whole lot of things I didn’t even think to ask about.

NOTE: I did not get a copy with the Covid introduction. I tried to find this intro elsewhere, but couldn’t find it.


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