On July 11th, Dr. Monica Gandhi published her book titled Endemic: A Post-Pandemic Playbook. The book is summarized on Amazon thusly:
Endemic squarely reckons with our present condition: attempting to comprehend and live with a new respiratory disease and face the coming variants and next pandemic with reason, science, understanding, courage, and compassion. It does not shy from rigorous scrutiny, and it pulls no punches about where we have been, where we find ourselves now, and how we ought to manage the virus in the coming years. “Endemic” refers to the features of a virus that make it either eradicable or controllable. SARS-CoV-2’s features make it non-eradicable. However, if we use tools we already have, living with an endemic virus is possible and does not have to be disruptive to society.
This book is a clarion call for reason while also assessing the story, science, and politics thus far with its hits and misses, and providing a roadmap for the future of COVID-19 variants and future epidemic crises. Dr. Gandhi’s 10-point plan is the center of this book and will serve to guide us today and into our future. Her roadmap includes:
- The expansion of equitable vaccine distribution
- Easing restrictions
- Emphasizing harm reduction over coercive or punitive measures
- Encouraging outdoor activities
- Avoiding school closures
- Understanding the long-term economic and psychological consequences of sustained lockdowns
- Eliminating ineffective measures
- Reassessing testing policies and practices
- Increasing access to outpatient therapies and prophylactics
- Focusing on better preparation for future pandemics
Dr. Gandhi brings her unique blend of professional history, training and experience, academic authority, and role as expert commentator for general audiences to bear. Endemic is well-researched, clearly reasoned, accessible, and absolutely essential for readers who are confused by inconsistent mandates and policies—and who want to be prepared for the future.
Dr. Gandhi certainly has impressive credentials. According to her biography on Amazon:
Monica Gandhi, M.D. is Professor of Medicine and Associate Division Chief of the Division of HIV, Infectious Diseases, and Global Medicine at UCSF/ San Francisco General Hospital. She also serves as the Director of the UCSF Center for AIDS Research and the Medical director of the HIV Clinic at SFGH (“Ward 86”). Dr. Gandhi completed her M.D. at Harvard Medical School and then came to UCSF in 1996 for residency training in Internal Medicine. After her residency, Dr. Gandhi completed a fellowship in Infectious Diseases and a postdoctoral fellowship at the Center for AIDS Prevention Studies, both at UCSF. She also obtained a master’s in public health from the University of California, Berkeley in 2001 with a focus on Epidemiology and Biostatistics. Dr. Gandhi is arguably among the most distinguished infectious disease experts practicing today as well as being one of the few women with such a recognized platform. She supervises many predoctoral students, fellows, residents, and faculty at UCSF and has co-authored or contributed to 18 scholarly books. She is overseeing 11 ongoing research awards and grants from the NIH and the NIAID.
Dr. Gandhi has also been a ubiquitous media presence during the pandemic. Her Amazon biography continues:
Dr. Gandhi has received dozens of awards, spoken at hundreds of conferences, keynoting many, held a handful of prestigious leadership positions, performed thousands of hours of public service, and served as a mentor and advisor to women in global health research studies. During the COVID-19 pandemic, she has contributed more than 20 original, peer-reviewed research articles and written more than 40 editorial and opinion pieces for media outlets including The New York Times, NPR, NBC News, BBC, Atlantic, Washington Post, New Yorker, Los Angeles Times, San Francisco Chronicle, The Guardian, Vox News, WIRED, and more.
I don’t intend to read Dr. Gandhi’s book, though I am sure there’s much that I would agree with. Though she initially said, “It’s simple math. We don’t need to vaccinate those under 11 to get to herd immunity”, she eventually wrote an passionate defense of pediatric COVID vaccination, for example. It’s also likely she will discuss uncontroversial blunders, such as the CDC’s botched tests at the start and the tragedy of those who died due to anti-vaccine misinformation. Who could argue with her call to encourage outdoor activities?
However, these potential areas of agreement aside, Dr. Gandhi unleashed a firehose of poor predictions and bogus statistics throughout the pandemic, always minimizing the virus, of course. If you are unfamiliar with her overwhelming litany of pollyannaish prognostications, repeated declarations of herd immunity, and mocking those who disagreed- “I genuinely with all my heart apologize for anyone who continues to try to scare you about variants“- I suggest you familiarize yourself here: Pandemic Accountability Index, Mehdi Hasan, me, and me again.
It’s possible that Dr. Gandhi’s book will actually “pull no punches” and address her own errors, though an honest accounting would take several lengthy chapters, trust me. However, no matter what her book says, its most troubling part is loudly displayed on its Amazon page- the adulation it received from prominent figures in American medicine. Here are their tributes, interspersed with a very small sample of Dr. Gandhi’s false forecasts and the cumulative death toll on that date:
Throughout the pandemic, I often turned to the compassionate and clearheaded voice of Dr. Monica Gandhi. Drawing on her experience from the frontlines of HIV, she was able to make meaning from mountains of data and deftly balance an approach that helped keep people safe while reducing harm. Now, eyes cast to the future, she outlines a thoughtful and reasoned plan to help prepare for the next pandemic.”–Sanjay Gupta, M.D., CNN chief medical correspondent and #1 New York Times bestselling author of Keep Sharp and World War C
Throughout the COVID-19 pandemic, Dr. Monica Gandhi has emerged as a unique voice, passionately arguing for an approach that balances the threat of the virus and the harms of mitigation strategies. In this timely, lucid, and well-referenced book, Gandhi lays out the lessons of the pandemic – lessons that should be heeded as we manage the continued threat of Covid and plan for the next pandemic. An essential addition to the Covid lexicon.” —Robert Wachter, M.D., Chair, Department of Medicine, UCSF and New York Times bestselling author of The Digital Doctor
As we look back on the years 2020-2022 and forward to the coming decades, Dr. Monica Gandhi’s bold work will be among the few go-to analyses helping to set the stage for the long-term playbook we can rely on in future epidemics.”–Emily Oster, New York Times bestselling author of Cribsheet and Professor of Economics, Brown University
A heartfelt and urgently needed exploration of the success and mistakes of the COVID-19 response. This vivid account from a doctor and mother on the frontlines of the pandemic can help us all do better in the endemic period we are now entering–still so surrounded by uncertainty. Here is a sane and reliable guide to a better future.” — Chris Beyrer MD, MPH, Director, Duke Global Health Institute
Dr. Monica Gandhi’s work in global HIV gives her a long view of equity in antiretroviral treatment and prevention access. She is also an active infectious diseases clinician. This provided her with a unique, pragmatic view of the COVID-19 pandemic in terms of the need for global vaccine and treatment equity, as well as universal healthcare access coverage.”– Eric Goosby, M.D., former Global AIDS Ambassador under President Obama
As a specialist who has been on the forefront of the HIV/AIDS epidemic, Dr. Gandhi is no stranger to the fear, stigma, discrimination, and uncertainty a new disease can create. Her book provides assurance and clarity as she reflects on the lessons learned from the HIV response and discusses what went right and what went wrong in our response to the COVD-19 pandemic and how to prepare for the next public health emergency.”–Carlos del Rio, M.D., Professor of Medicine, Emory University School of Medicine; President, Infectious Diseases Society of America
For years, Dr. Gandhi has been a faithful and diligent force on the HIV/AIDS front line, especially in terms of global equity. She has now turned her years of expertise into an invaluable tool—a handbook—for future medical crises.”–Ingrid Katz, M.D., Professor of Medicine, Harvard Medical School and Faculty Director, Harvard Global Health Institute
Dr. Gandhi has been a star presence in the medical community for many years, particularly in the fight against HIV/AIDS. As we face the future of epidemics both in the U.S. and abroad, it’s people like Dr. Gandhi who we can rely on to show us a clear path forward. With this book, Dr. Gandhi provides a solid map.”–Jeffrey Flier, M.D., former Dean, Harvard Medical School
And this is how medicine circles the wagons to protect its own and rewrite the history of the pandemic.
To be clear, I don’t think Dr. Gandhi should be be “silenced” or personally attacked in any way. However, in a better world, leaders of American medicine would have matched the courage shown by some medical students and simply corrected misinformation spread by their fellow doctors. At a bare minimum, they could have said nothing. They had no obligation to lavish praise on someone who repeatedly polluted our COVID landscape with obvious falsities- “children are not more susceptible to the delta variant, they’re threefold less likely to get any infection with any variant with any ancestral strain, and they’re half as likely to spread it“- and falsely pacified people the worst was over, when in fact the worst was just around the corner.
Sadly, “post-pandemic playbooks” of denialism and revisionist history are more likely to hold sway than mine.
