The Coming Plague: Newly Emerging Diseases in a World Out of Balance

If Garrett were writing this book today, do you think any of its major elements would be different than they were in the mid-1990s?

Garrett mentions many social factors that provide opportunities for epidemics to emerge and other factors that amplify its continued growth. Can you think of any other factors she didn’t mention but which might also serve to allow infectious diseases to spread?

Twenty-five years after Garrett’s book was published, the world experienced a major pandemic that was not seen since the early twentieth century: the emergence of Covid-19. The virus behind the pandemic was part of a well-known family called coronaviruses, but nowhere in Garrett’s book does she mention the threat of coronaviruses. Do you think this absence points to a weakness in Garrett’s book, or does it serve to underscore the larger point she is making?

Consider the state of global public health today. What changes could be made to improve its readiness to respond to infectious disease outbreaks?

Garrett presents the optimism of early efforts at disease eradication as naïve. Do you agree? Can you think of ways in which optimistic perspectives on medical progress might be an asset rather than a liability?

Garrett occasionally uses the metaphors of war and predator/prey to characterize our relationship with infectious disease microbes. Do you think these metaphors give an accurate picture of the relationship? Why or why not?

Heeding Garrett’s call for humanity to view the world from an ecological perspective would require all nations to coordinate with each other on major environmental and social policy issues in addition to public health policy. Do you think that is likely to happen? Can you think of anything that might make it even more likely?

Consider Garrett’s various stories of disease outbreaks throughout the book. Which of the stories captured your interest the most, and why?