"Silent Invasion" by Deborah Birx

The book “Silent Invasion: The Untold Story of the Trump Administration, COVID-19, and Preventing the Next Pandemic Before It’s too Late”, by Deborah Birx, gets a formal review from me. The publication data is Harper, hardcover ISBN 978-0-06-320423-2, with Preface (to Roman 12), Prologue, 20 chapters, Epilogue, to p. 474, followed by appendix, acknowledgements, and Index, to p. 506.  Part II starts after Chapter 10, in the summer “reopenings” of 2020. Amazon has a SiteStripes link.

Dr. Deborah Birx was the lead advisor to the Trump administration from early in 2020 until the end. She has decades of public health experience, including time as a colonel in the US Army.

She would often appear with the president at public announcement forums at the White House.  Her manner of speaking is soft and somewhat matter-of-fact.

The book is very long and expansive, but from the opening she makes it clear she perceived the potential gravity of the pandemic very early in 2020, before she was hired on to the Trump administration. The essential difference between this virus and the earlier forms of SARS or MERS was that it could be spread from nose and throat through aerosols even before there were symptoms, and often there never were symptoms in many healthier young people. She does not go much into challenging the theories as to how the virus got started in Wuhan, China. As an aside, I would mention that the very recent stories about finding more evidence of an origin in the wet market still have not identified specific animals of origin, and it seems logical that the virus could have been brough there (two strains) by individuals already infected, creating superspreader events that created the appearance of origin at the market. With a natural animal origin, why weren't there outbreaks in other cities in China at the same time?

The president and others were always trying to play down the threat.  Remember when Trump “promised” we would be back to normal Easter Sunday 2020?  In the summer Birx would travel around, trying to advise each state on how to manage the restrictions.  It is true, that our federal system makes it difficult to impose national lockdowns (or even martial law) everywhere, as most of this is up to governors of states. 

Some of the red states were stricter at first than the public realizes. Texas closed most indoor bars and restaurants for a time. That would included my favorite spots on Cedar Springs in Dallas, which were alive and well during my most recent visit in May 2022.

For individuals, there was a moral dilemma as she states on p. 182, at least one partial fraction of it with regard to masks: "I don't have any symptoms. I'm not going to infect anyone else so why do I need to wear a mask if it isn't going to keep me from getting infected?" My impression is that maybe 50% of cases in younger adults had brief or no symptoms. even before vaccines.

She spends some space on the ideas of Dr. Charles Atlas (who 'shrugged' according to a chapter title) who wanted to let the virus burn out in a younger healthy population, while segregating older and more vulnerable people from society.  There is some problem with that in that natural infection with the SARS_CoV2 virus does not produce 'sterilizing immunity' and reinfections, although often milder, are inevitable. But moreover how would you segregate the more vulnerable persons?  I turned 77 in July 2020 so this question would affect me.  The answer could have been forced podification and complete destruction of my own agency as a person. I certainly could have been separated from the infrastructure to maintain my sites (which frankly could have been viewed as “inessential work”).  My own experience in 2020 was to take one or two day trips to a rural area alone by car a month for 'outdoor recreation' alone, which was permissible even with the first stay-at-home order in Virginia on March 30, 2020.  I found some spots within 100 miles of home I had never visited.

She gives interesting coverage to the pandemic for indigenous tribes.  Tribal members have lost income due to casino closures, but moreover have been susceptible because of higher rates of diabetes and possibly genetic susceptibilities.

Avi Schiffmann explains the R0 number for an infectious disease

She covers Trump’s own Covid infection in early October 2020 relatively briefly, as it seems that he recovered miraculously from having been seriously ill.

(Posted: Monday, August 1, 2022 at 3 PM EDT by John W Boushka)