Introductory public health teaches that you should “know your epidemic”: understand the distinctive epidemiological and social ways in which each pandemic is its own distinctive creature. Historian Peter Baldwin has long made the case for knowing your country. His earlier books have shown how national history and politics, as much as science, diseases, or regimes, explain responses to diseases as different as cholera and HIV/AIDS. Fighting the First Wave, Baldwin's well-written and thought-provoking study of government responses to the first wave of COVID-19 in 2020, draws on his previous work and contemporary media sources to show how issues such as economic trade-offs, science, and individual responsibility were framed in different countries.
Baldwin argues that COVID-19 is the same disease worldwide, but not the same pandemic. The book uses a comparative approach, which includes the serious analysis of Sweden that global debates need. In 2020, Sweden pursued a distinctive low-restriction path and became an unlikely darling of the world's libertarians. It was unusually deferential to public health expertise—and its public health experts guided it to policies that much of the world's public health voices opposed. As Baldwin argues, Sweden's approach was fundamentally incoherent, asking for voluntary social distancing while avoiding rules on the grounds that people would not obey them. Recognizing the subtleties and contradictions of Sweden's policies does not just shed light on Sweden; it also makes clearer the thinking of other governments as they considered ideas such as “herd immunity.”
Sweden and Baldwin's other cases shed light on the broader politics of “epistocracy,” or rule by experts. Professionals in public health, medicine, and science often claim that their expertise should let them guide policy, and political leaders frequently claim to be following science. In practice, despite would-be epistocrats’ claims to influence on pandemic policymaking, political leaders remained in charge. Expert advice, meanwhile, was not always unified, with different disciplines, ideas, and national traditions shaping both “the science” and the advice that governments heard.
Compared with earlier pandemics, scientists understood the novel coronavirus with amazing speed and effectiveness—most notably in vaccine development but also in understanding transmission and treatment. Scientific achievement was not matched by political unity. Democracies hobbled themselves. In what political scientists would recognize as blame avoidance, their leaders often took weaker and later action than the contemporary science would have suggested.
How, then, does science get used? Western democracies largely failed to seek or successfully get compliance with tough measures but invested in treatment and vaccines. The countries that could effectively vaccinate, they hoped, would be able to leave the pandemic behind. Since the book's publication, the scale of vaccine resistance in places as different as the United States, Poland, and Hong Kong has shown the limits even of technology. Governments’ bets on social behavior, in vaccines as in public health restrictions, do not always pay off. With the hindsight of 2021, it seems in particular that experts and governments often underestimated the power of, frankly, quackery.
There are millions of publications on COVID-19. Why should this book be one that people read? First, it correctly targets the first wave, 2020, as an unusually valuable opportunity to learn about political systems facing a novel crisis, and it poses and answers excellent questions. Second, it focuses thinking on the interaction of new problems and older approaches—how to know your epidemic and know your country. Finally, it focuses our attention on underlying continuities and changes in how governments think about populations. One of the clearest themes of the book is the difficulty that policymakers face in understanding their people and, perhaps, themselves.
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