Public service bravery: Michael Lewis' The Premonition shows what it takes to fight a pandemic

In The Premonition, as he tends to do, Michael Lewis turns everyday people willing to tell us what we need to hear at a critical societal moment into a cast of characters we can't help but cheer on, but also leave wishing the world had more brave voices such as these.

As the COVID-19 pandemic emerged and evolved, complacent government officials and entrenched bureaucratic institutions, in this case the Centers for Disease Control and Prevention, sometimes become disappointments at a time when the public needs them most.

Fortunately, there are those -- inside and outside of government -- willing to question the status quo and make the hard choices to truly serve the mission our democratic institutions expect from their leaders, especially in big moments of need.

The Premonition cast of braveys include Charity Dean, then assistant director of the California Department of Public Health; the Wolverines, a group of former federal government health officials and pandemic experts and enthusiasts; and University of California San Francisco's Joe DeRisi; amongst others.

Dean's first unfortunate encounter with CDC came during her time as the lead public health official for Santa Barbara County when a meningitis B outbreak happened at the University of California Santa Barbara.

"The CDC did many things," writes Lewis. "It published learned papers on health crises, after the fact. It managed, very carefully, public perception of itself. But when the shooting started, it leaps into the nearest hole, while others took fire."

"I was always saying to the CDC, 'This is your job! Do your job!'," says Dean. "But after the UCSB outbreak, my motto was, 'Stop waiting for someone to come and save you. Because no one is coming to save you.'"

"In the end I was like 'Fuck you,'" says Dean of CDC's response to her request for support. "I was mad they were such pansies. I was mad that the man behind the curtain ended up being so disappointing."

And DeRisi on his interactions with the federal government when trying to explain his proven genetic sequencing solutions that helped to fight some rare infections:

"The government was meant to fill in the blanks, but the United States government by now mystified Joe," writes Lewis. "He'd visited the CDC to explain the new genomic technology, only to be met with boredom and blank stares. In the Food and Drug Administration there was one woman -- a single human being -- trying to curate the academic literature so that doctors and patients could easily access new knowledge. She'd taken it upon herself; no one had asked her to do it."

"It's often individuals who pick up the baton, and they're not doing it as part of their day job description," says Joe. "Scattered throughout those organizations there are these people, but they aren't organized, trying to compensate for the deficiencies in the system."

And Carter Mecher, the Wolverines' spiritual leader and co-author of the U.S. government's pandemic response strategy who, with his email missives, began to build a larger, influential following "sitting at a desk in his bedroom in Atlanta ... creating a clearer view of the virus in China than anyone in the United States government."

In an email to the Wolverines, Mecher vents his frustrations about the Department of Veterans Affairs and C

"I am still having issues in VA with leaders avoiding the use of the term pandemic and then not wanting to implement key portions of the VA pandemic plan because this is not a pandemic," he wrote. "They will not say or use that word ... They expect to see the term pandemic used by CDC and WHO. CDC continues to say this is not a pandemic. ... I know this is not CDC's intent but it is creating problems for bureaucrats who suffer from malignant obedience."

The obvious conclusion was that it was left to the states to take matters in their own hands, but even they weren't immune from the same shortcomings.

Dean, following the U.S. Digital Service mantra of "find the truth, tell the truth," began stepping on state government toes, including those of her boss, California Department of Public Health Director Sonia Angell. The two differed significantly on how to address the coronavirus response. At one point, Angell banned Dean from using the word 'pandemic' and sharing her whiteboarded data narratives of the pandemic's trajectory.

"She told me I was scaring people," said Dean. "I said 'Shit, they should be scared.'"

Ultimately, Dean was excluded from email conversations and meetings related to California's pandemic response. However, she began formally documenting her opinions in writing and showing up to meetings uninvited accompanied with a large, and loud, binder of data.

In one anecdote, Angell was scheduled to brief California Governor Gavin Newsom and top state officials on the new virus. Initially, Dean was told she wasn't needed, that Angell would deliver the briefing. Perhaps unsurprisingly, at the last minute, Dean was asked to do it.

Lewis:

A system was groping toward a solution, but the solution required someone to be brave, and the system didn't reward bravery. It was stuck in an infinite loop of first realizing that it was in need of courage and then remembering that courage didn't pay. Charity didn't think of it this way, but it was striking how often the system returned to her and very nearly sought her leadership, without ever formally acknowledging its need.

Angell eventually resigned from her position in August 2020. Dean was the obvious choice to replace her, but she eventually left state government work and founded The Public Health Company to "protect businesses and communities from infectious disease."

Then advisor to Gavin Newsom and California's unofficial chief dot connector Mike Wilkening gets only a brief mention, but is the linchpin to finally connecting Dean's subject matter expertise to former Obama White House officials Todd Park and DJ Patil's knowledge of data science that begins to help better map the coronavirus' impact on the state.

The pandemic response was a cumulative breakdown of many familiar government shortcomings -- procurement, technology, communications, culture, project management, executive ego, to name just a few -- but fundamentally, it was a lack of courage to do and say what needed to be done and said in the moment.

"You let the falsehood continue until slowly the falsehood takes over," says Dean. "By the time you're done, you are no longer just filling blank spots. You have the burden of maintaining optics. It's all optics." (Another USDS mantra is "optimize for results, not optics.")

Too often, we treat crises and disasters as heroic moments for public servants to step up and shine. The reality is that every day there's a crisis for someone in need, and the sense of urgency is immediate. When it comes to public service, whether you're working on the inside or out, every day is an opportunity to be brave and deliver on millions of people's needs.

Now more than ever, government needs a culture of courage.

The Premonition isn't an anti-government narrative. It's a call to action for anyone -- inside and outside public service -- to speak up and do what's right, even when everyone around you is afraid or isn't the right leader for the moment.

Fortunately, when we needed them most, The Premonition's band of braveys were there for us.