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Hendra, Ebola, malaria, SARS, XDR-TB, Q fever, simian foamy virus, Nipah, and influenza. One of these bugs, or an as yet undiscovered cousin, will likely kill a few hundred million of us someday soon. It isn’t if, as many of the scientists Dave Quammen interviews across his new book repeat, it’s when, a when it happens no one knows when.
David Quammen’s Spillover, surveying a variety of roads a wildlife pathogen might take to a deadly human infection, reads like a gothic thriller, at 500+ pages epic in scope across levels of biocultural organization and locale. DNA to global geography. Quammen’s Montana hometown to the deepest rainforest.
As he has in his other books, Quammen here’s a generous narrator, patiently making complex ideas plain to an audience he repeatedly addresses across the proverbial canteen bar as fellow travelers. He roughs us through the places he describes, not only through the muck in the field, but in the lab and in and out of concepts. We’re taken 0-60 on the differences between screening for antibodies and isolating a virus and through a history of mathematical modeling of susceptibles, infecteds and recovered.
Of course, people can go to a faraway place or outlandish idea and not see a damn thing. Indeed, while we come off churlish knocking good people for good work, Quammen’s book is so well-written, so fleshed out, so comprehensive that like Laurie Garrett’s tomes it gives the impression of an authority it doesn’t quite possess. Think on the shitty conversationalist who refuses anyone else a word in edgewise.
The same can be said of the scientists Quammen covers, with whom he throws in unconditionally, querying them for guidance rather than cross-examining for answers.
Don’t get me wrong, many of the scientists and medical staff Quammen tags along with are brave and bright beyond belief. Spillover channels George R.R. Martin, killing off its characters with aplomb. One researcher bites it in a bush plane crash. Sixty hospital staff in Kikwit are eaten by Ebola. Doctors and nurses across Asia took the biggest blasts of secondary SARS infection. Malaria killed evolutionary biologist William Hamilton, at the time playing an epidemiological Livingstone looking for HIV’s Congolese source.
But we would do well to add the more jaundice view missing here. Leaving aside the field’s Olympic plagiarism and backstabbing, disease scientists are actors within a broader political economy that pigeonholes many a researcher to an epistemological script. Not only within scientific metaphysics, but across naked economic interests. Several of the scientists Quammen interviews are flat-out mercenaries, taking Cargill money, for instance, to investigate outbreaks—vis-à-vis palm oil in Indonesia, for instance—of Cargill’s own making.
If these researchers profit from their sins of commission, by taking these prevaricators at their word, even for what he genuinely believes to be a greater good, Quammen suffers (and inflicts) a bout of traumatic bonding.
What aim such noble sacrifice? The Big Idea Quammen flogs is that new diseases—viruses, bacteria, fungi, protists, prions and worms spilling over from wildlife—arise out of human impacts on the population biology of host and pathogen alike,
Make no mistake, they are connected, these disease outbreaks coming one after another. And they are no simply happening to us; they represent the unintended results of things we are doing. They reflect the convergence of two forms of crises on our planet. The first crisis is ecological, the second is medical. As the two intersect, their joint consequences appear as a pattern of weird and terrible new diseases, emerging from unexpected sources…
These sources? Previously marginalized pathogens turn ecological opportunity across suddenly juxtaposed landscapes into an evolutionary payoff. Coxiella burnetti, the bacterium behind Q fever, has infected
dairy cows in California, sheep in Greece, rodents in North Africa, and bandicoots back home in Queensland. It passed from one species to another in the form of miniscule airborne particles, often dispersed from the placenta or the dried milk of an infected female animal, inhaled and then activated through the lungs, or taken directly into the bloodstream from the bite of a tick.
In essence, causality—and any effective intervention—is found in the field, both quite literally and as a philosophical premise, rather than in the object, say, in the form of a bacterium or any single host population. The connections organisms make (and break) with each other embody the pathways over which pathogens evolve their distinctive adaptations.
Quammen places blame for the shifts in the landscape driving pathogen spillover squarely on humanity’s shoulders, including population growth, global transport and travel, climate change, deforestation, and domesticated animals (which, for instance, it overtreats with prophylactic antibiotics and transports across great distances).
Explaining the ecosystemic dependencies out of which new pathogens arise isn’t nearly enough, however. Quammen rarely touches the processes occurring farther upstream. Pathogens are embedded in circuits of capital in such a way as to reverse conclusions based on ecology alone.
Take highly pathogenic H5N1, the bird flu, which almost certainly emerged in the southeastern Chinese province of Guangdong in 1996 before spilling over into Hong Kong a year later. When we include the economic relationship Hong Kong and Guangdong share, cause and effect shift direction.
By the 1990s the Pearl River Delta had returned to pre-Revolutionary dynamics whereby the now newly reintegrated Hong Kong turned back to acting the proverbial front of the store, providing capital and marketing to Guangdong—the back of the store—where industrial production of unnerving scale continues to this day. Indeed, at the time of H5N1’s emergence—and SARS’s, which also arose in Guangdong—4/5 of Hong Kong’s foreign direct investment went to Guangdong, including backing the shifts in agriculture and land use implicated in the new infections there.
Contrary to the morality tale that repeatedly characterized Hong Kong as some innocent victim, Hong Kong proves as responsible as Guangdong for H5N1’s emergence.
Or take Quammen’s dispatch five klicks south of Yokadouma, Cameroon, at Mambele Junction,
where Karl Ammann saw chimpanzee arms stashed under the hood of a log truck. It was also one of the locations featured in Bradon Keele’s paper on the chimpanzee origins of HIV-1. Chimp fecal samples from hereabouts had shown high prevalence of the virus in its most fateful form. Somewhere very nearby was Ground Zero of the AIDS epidemic.
Exactly the travel floor show at which Quammen’s advance reviewers hooted and hollered. But the characterization confuses mechanism for causality. It’s true, the virus first emerged in Africa (although unlikely by the nigh on racist caricature of a reluctant bushmeat hunter Quammen fantasizes at the heart of his HIV chapter). But the causes aren’t African alone.
Mike Worobey’s group dated the emergence of HIV’s group M, the clade that seeded the pandemic, to 1908, give or take fifteen years. In this time frame French and German colonial administrations competed for land and labor, radically altering the region’s landscape and social order.
As Walter Rodney describes, African labor was redirected by force and economic compulsion to producing for European export. The regime melded and juxtaposed pre-colonial and provincial social behaviors, including population fragmentation, cycle migration, sex and age biases urban and rural, with sex a commodity.
Clear-cutting meanwhile broadened the wildlife-human interface. Animals, and their pathogens, until then at one and the same time more tightly integrated at the level of the local village and more marginalized at the regional scale, became more exposed to the new order. In short, as the forest’s edge grew in extent, so did the epizoological traffic.
Deforestation concomitantly turned bushmeat from a subsistence food item into a commodity that supported logging camps in the thousands and, later, farming towns growing on the edges of the contracting forest. Associated logging roads and rail integrated the deepest forest with regional cities.
In short, explanations of HIV’s origins must be extended to an imperial epizoology, out of Africa and to Europe’s capitals, a framework establishment researchers have started to assimilate if by dint of overwhelming evidence.
Even the methods scientists use to characterize diseases are freighted with such histories. As the geographer Peter Gould described, the SIR modeling Quammen takes the time to teach us is loaded with political assumptions, disappearing complex social epidemiologies inside billiard-ball simultaneous equations and cellular automata.
Quammen, coming off the folksy neoliberal, does address economic impacts on disease emergence, but in two ways that conveniently obfuscate responsibility for a particular economic order. First, he’ll detail an impact without naming names: deforestation, agriculture, antibiotics, etc. Indeed, not a single corporation involved in said disturbances is named in the book.
Second, he’ll riff on a global South informal economy, local palate, or illegal trade cutting into forest and food web, but fail to address the regional neoliberalism and structural adjustment New York and London bankroll, turning subsistence consumption into an export economy. Quamman’s cynicism is naively obstructionist.
There are exceptions. Quammen’s description of the agroeconomics around Q fever in the Netherlands bears repeated reading,
Among the first things he mentioned, when I asked about the character of Herpen as a community, was the big change that had come in local farming practices within the past decade: the increase in goats.
This change had actually started back in 1984, when the European Community established quotas on cow milk that pushed Dutch farmers away from dairy cattle. Many continued as dairymen but started milking goats. The dairy-goat trend grew stronger after 1997 and 1998, when outbreaks of classical swine fever (caused by a virus, but not zoonotic) led to mass cullings of pigs, and many pig farmers, hard hit financially and scared about a recurrence, sought an alternative line of husbandry…From a low of about 7,000 animals in 1983, the total Dutch goat population had increased to 374,000 by 2009…
Another shot gave a clearer view of what he called a “deep litter shed,” the standard arrangement for housing hundreds or thousands of dairy goats. The shed had a concrete floor, recessed below ground level so that it could contain weeks’ or months’ worth of bedding straw, goat shit, and urine, a savory mulch of organic waste that grew ever deeper and, warmed by decay, offered a lovely culture medium for microbes.
But such glimmers aren’t translated to the larger context. Indeed, Quamman and the One Health devotees he interviews prescribe scut work more tuned to cleaning up the next outbreak than preventing it,
The practical alternative to soothsaying, as Burke put it, is “improving the scientific basis to improve readiness.” By “the scientific basis” he meant the understanding of which virus groups to watch, the field capabilities to detect spillovers in remote places before they become regional outbreaks, the organizational capacities to control outbreaks before they become pandemics, plus the laboratory tools and skills to recognize known viruses speedily, to characterize new viruses almost as fast, and to create vaccines and therapies without delay.
Emergency capacity is always critical. But that’s what you’re left with when you refuse to say the other ‘c’ word.
While Quammen and the researchers he champions see and hear viruses of a sort, others, a growing group, just as ensconced in representative sampling and statistics, see and hear viruses of another kind completely. These pathogens, our next generation in science is learning, transmit by surplus value and margin call, wearing molecular suits of the finest cut.
Rob Wallace is an evolutionary biologist and public health phylogeographer currently visiting the Institute for Global Studies at the University of Minnesota. He blogs at Farming Pathogens.