Networks and systems are recurring themes throughout Ferguson’s previous books and it is a subject he returns to in Doom, demonstrating how pandemics are likely to become more frequent as urbanization , agriculture and globalization all increase. Ferguson also considers how throughout history medicine has more often than not being playing catch-up with disease, often falling back on non-pharmaceutical interventions such as the Habsburg’s plague ‘sanitary cordon’ with the Ottoman Empire, described in 1835 by English traveler Alexander Kinglake;
“If you dare to break the law of the quarantine, you will be tried with military haste; the court will scream out your sentence to you from a tribunal some fifty yards off; the priest..will console you at dueling distance, and after that you will find yourself carefully shot…”
Variations on this approach were the primary ways of slowing the spread of infection until the Asian flu epidemic of 1957, which the USA combatted not through quarantines and closures, but through the speedy vaccination response lead by Maurice Hilleman. Ferguson suggest that this was enabled in large part by the Cold War culture of the time, allowing Hilleman to bypass ‘the bureaucratic red tape’, leading to mass vaccinations starting in the US just three months after the first cases were reported.
Throughout Doom Ferguson returns to the roles played by leaders and governments in preparing for and responding to disasters. Ferguson posits that leaders should be seen as ‘hubs’ in large complex networks, rather than all-seeing masters perched atop hierarchies;
“If they are well connected to the political class, the bureaucracy, the media and the wider public…they can be effective leaders. To be isolated within the structure of power is to be doomed to impotence, no matter how grand one’s title.”
By this logic, whilst leaders are important they are just part of a complex system of economic, social and political relationships. But if the buck doesn’t stop at the top where does responsibility actually lie?
Ferguson suggests we look for ‘active’ and ‘latent’ errors when analysing the anatomy of a disaster. Active errors are generally at the ‘sharp end’ with frontline staff and are skills, rules and knowledge based. Latent errors reside at the ‘blunt end’ (most often with middle management) and are caused by the reallocation of resources, the change in scope of a position or adjustment of staff on particular tasks. The sinking of the Titanic is held up as a disaster that combined both active and latent errors, while the Challenger space shuttle explosion was caused primarily by latent errors behind the scenes.
Doom’s final chapters look at the likely outcomes from the COVID-19 pandemic. Ferguson strays into more political waters here and some may contest the predictions he sets out for the future, particularly around the possible economic impact and developing Cold War II with China. Ferguson’s broader conclusion that ‘our plague is likely to have the biggest disruptive impacts on places where progress has already ceased and stagnation set in’ rings true, though.
Whilst perhaps not initially the most enticing sun-bed companion, Doom is a remarkably engaging and entertaining read. Drawing on an eclectic range of examples and sources, from Peter Cook to Pol Pot, Ferguson places our current situation within a clear historical context and sets out the challenges we must address if we are to avoid a future mimicking Dad’s Army’s Private Frazer. A timely study that will help ensure we (aren’t) all doomed.
