The book amplifies his voice as one of the medical world’s leading critics of policymakers, which has already been heard loudly through social media and Lancet editorials. Although the UK government receives Horton’s most extensive criticism, his most intense venom is directed at the Trump administration for not only failing to protect American citizens but also undermining the global solidarity that is essential when fighting a pandemic. He is particularly scathing and unforgiving in his assessment of President Trump’s decision to cut US funding of the World Health Organization.
Horton calls the UK response to Covid-19 “the greatest science policy failure for a generation”. As befits the editor of a publication with a history of exposing medical corruption and cant in high places, Horton is properly angry: like a compositor punching out hot type in pre-digital days, his prose is full of steaming barbs. You can almost smell his contempt on the page... This is a polemic of the first order. However, while Horton’s barbs hit the target, he is not a wholly reliable narrator. According to fact-checking organisation Full Fact, Johnson did not advocate a herd immunity strategy on ITV’s Good Morning; he merely said this was a theory on how to deal with the virus, but it would be better to reduce the burden on the NHS during the peak of the disease. Horton is on firmer ground when he points out that by the end of January, the Lancet had published five papers setting out the risks of a global pandemic and how Sars-CoV-2 could be controlled using track-and-trace measures successfully employed during the first Sars outbreak in 2003.
Horton believes we need to learn to co-operate more and consume less; stop travelling and find more harmonious ways of living with the natural world. I say amen to that. He is righteous in his anger at the complacency and lack of leadership shown by politicians and the medical establishment. But we could also have done with some more ideas about what the hell we do next.
Yet for all its omissions, and its patently partisan political outlook, this book strikes me as a valuable response to a crisis that in one respect is utterly bewildering. At this time last year, the two countries rated by most of the world as the best prepared to deal with a lethal pandemic were the United States and the United Kingdom. The death tolls tell a different story. It is no longer good enough to pretend, as Johnson continues to do, that Britain is on the verge of “world-beating” breakthroughs in testing and tracing or anything else. It’s far too late for jingoism, and you don’t need to be as angry as Horton to wonder what went wrong.