Lyman BioPharma Consulting LLC

Advice and Resources for the Biotech Industry

Advice and Resources for the Biotech Industry

Stacks Image 1108

Stacks Image 1106

Summer Reading List 2021

Pandemic restrictions are really lifting now, and while I can’t go inside my local library, I can still order books online and pick them up to go. Are you looking for some good reads? It’s time once again for my annual roundup of some of the best books I read this year. As usual, my focus is mostly on nonfiction tales from the world of science, medicine, and technology. A master list of all books that I recommend can be found here, and you can also check out my previous book recommendations on the Previous Op-Ed Articles blog page on my website. You might be surprised to learn I actually got much less reading done during the pandemic. That’s because I spent so much time on educating people online about the pandemic, and especially about the vaccines. These efforts heavily influenced my reading list this year, as you will see below.

First up is Steve Olson’s enlightening new book The Apocalypse Factory: Plutonium and the Making of the Atomic Age (2020). I found it thoroughly engaging. It’s a history of the discovery of the large unstable elements (uranium, neptunium, and plutonium), and how they were transformed into atomic weapons by the Manhattan Project. Olson covers both the science involved, with description of how nuclear fission occurs and how chain reactions are created, along with the scientists who made these discoveries. Glenn Seaborg, Enrico Fermi, and Ernest Lawrence all figure prominently in the story. The heart of the book is the construction and development of the factories that produced the fissile materials that were eventually used in the Trinity, Hiroshima, and Nagasaki bombs. It’s hard to imagine what a massive undertaking this was, especially in desolate Hanford, WA where the plutonium was produced. Entire cities needed to be built quickly, with housing and dining halls capable of feeding thousands of workers. Designing the production facilities was a monumental achievement of science. The book does not shy away from discussing the legacy of the early atomic work, focusing on the destruction of Nagasaki with narratives provided by those who were living there when the bomb fell. It also explores the environmental nightmare associated with the cleanup and decontamination of the Hanford Nuclear Reservation, which is still ongoing 75 years after the end of WWII.

There are so many rumors flying around the world about vaccines, especially these days as the world anxiously works to vaccinate its way out of the COVID-19 pandemic. How do these rumors get started, and why is it so difficult to make them go away? That’s the subject of Stuck: How Vaccine Rumors Start and Why They Don't Go Away, by Heidi J. Larson (2020). The author is not an epidemiologist or a public health expert. She is a cultural anthropologist and Director of The Vaccine Confidence Project (VCP) at the London School of Hygiene and Tropical Medicine as well as a Clinical Professor, Department of Global Health, University of Washington, Seattle, WA. Professor Larson’s research focuses on the analysis of social and political factors that can affect uptake of health interventions and influence policies. Her particular interest is on risk and rumor management of vaccine development from clinical trials to marketing. She studies the various geopolitical, cultural, and religious factors that cause people to have doubts about vaccines, and explains how these lead to rumors that can spread very widely in a short period of time. Her background as an anthropologist sets this book apart from other books that explore the anti-vaccine movement. She acknowledges that misinformation and disinformation are a real problem, but her focus is on a lack of trust in institutions that lead to the rumors being started in the first place. Social media amplifies the spread of these rumors, but she argues that simply removing posts will not resolve the problem. It will only drive these rumors into other distribution systems. Emotions and decision making play key roles in why people develop a mistrust in vaccines, and science education alone will not solve this problem. The bottom line: it’s important to engage people and communities that have vaccine doubts, and not simply dismiss them.

For another look at dealing with those who are opposed to vaccines, consider reading Jonathan M. Berman’s Anti-Vaxxers: How to Challenge a Misinformed Movement (2020). This book takes a historical approach, looking at the development of vaccinations and the opposition to the procedure that have sprung up again and again. He discusses the Britain's Vaccination Act of 1853, which showed that people are wary of Government mandates. The author focuses on how using social and behavioral research to craft messaging. This approach can be used to combat the onslaught of misinformation that many people are exposed to every day. Privilege enters the story as well. Many people don’t vaccinate their kids not because they opposed vaccines, but because they simply don’t have access or can’t afford them. The COVID-19 pandemic is clearly having a significant worldwide impact on vaccinations for multiple reasons: parents are afraid to take their kids into a doctor’s office; they’ve lost their jobs and can’t afford vaccines; doctors are afraid of taking vaccines into remote area because they are afraid of bringing the pandemic along with them. Also covered in the book are Andrew Wakefield’s movie Vaxxed; Robert F. Kennedy Jr.’s campaign against thimerosal in vaccines, promotion of alternative “more kid friendly” vaccination schedules, and how religious exemptions are used to avoid vaccination even though none of the world’s major religions have any prohibitions from using them.

Although the anti-vaccine movement has been around since the start of vaccines, one paper alone is often attributed as the primary source of the anti-vaccine movement in recent decades. That paper, and the man who wrote it, is the subject of The Doctor Who Fooled the World: Science, Deception, and the War on Vaccines by Brian Deer (2020). The doctor in the title was British physician Andrew Wakefield, and the paper was an article published in 1998 in the journal The Lancet that claimed that there was a link between the measles virus and the development of autism in children. The study was quite small and only included twelve children. Even though the paper made no causal claim of the vaccine and autism, Wakefield suggested at press conferences that giving the vaccine should be halted until more research on the project was done. What wasn’t known at the time was that Wakefield had ties to, and received money from, lawyers who were planning on suing the vaccine maker, and was planning on making money by developing a diagnostic test for this new type of “autistic enterocolotis” that he had supposedly discovered. He eventually was charged with fraud amid conflict of interest allegations. His paper was retracted by The Lancet in 2010, the same year he lost his license to practice medicine in the UK. The book covers this story in great depth, and was written by the investigative reporter who spent years exposing this fraud. This story has been well covered in the news, but Deer brings the entire tale together and outlines the damages that arose from this single paper. The book reminded me of Margaret Mead’s quote, "Never underestimate the power of a small group of committed people to change the world. In fact, it is the only thing that ever has.” In this case, however, it was a change for the worse.

I’ll give a very strong recommendation for Isabel Wilkerson’s Caste: The Origins of Our Discontents (2020). This best selling, Pulitzer Prize winning book richly deserves the many accolades bestowed on it. It’s essentially a look at systemic racism, and to a lesser degree anti-Semitism (mostly in Nazi Germany), through the lens of the caste system most associated with India. The book looks at how these systems operate, how they came to exist and become widespread. Many practices in how one country deals with either minority groups or those considered undesirables become adopted by others (e.g. eugenics in the US helped pave the way for anti-Semitism in Nazi Germany. The descriptions of how racism evolved in the Jim Crow south, and the strains it puts on Black people still today are heartbreaking. It really does a thorough job explaining how systemic racism became established and how insidious it is at governing everyday interactions. It explores how societies develop to have at least one particular group that is meant to occupy the lowest rung of society for others to look down on and give thanks that they’re not a member of that group. This was the best book I read last year.

If you’re a fan of Malcolm Gladwell’s writing (and millions of people are), you’re likely to enjoy his latest book The Bomber Mafia: A Dream, a Temptation, and the Longest Night of the Second World War (2021). The book is essentially an historical look back at the development and use of bombardment as a war strategy during World War II. Different approaches were required for the European and Asian theaters due to the much greater distances involved in bombing Japan from territories controlled by US forces. Two major advancements drove aerial bombardment during WWII: the creation of the Norden bombsite (much more accurate than previous approaches), and the development of the Boeing B-29 Superfortress with it’s much greater range than other planes. Much of the thinking about how to conduct an aerial war evolved out of a newly created military base, the Air Corps Tactical School. Located at Maxwell Field in Montgomery, AL, it was established by the Army to plan out different uses of air power (the Air Force had not yet been created yet). Much of the book covers the different ideas and approaches taken by the military leaders, including Curtis LeMay, Haywood Hansell Jr., and Harold George. The book provides a riveting look at how moral dilemmas decisions that arise during war, such as the bombing of civilian areas, were made. Note that this book arose out of Gladwell’s Revisionist History podcast, so the story may be old news to folks who listen to that.

A few years ago I reviewed and recommended Bottle of Lies, Katherine Eban’s riveting tale of corruption and malfeasance in the Indian generic drug manufacturing industry. On it’s heels comes China Rx: Exposing the Risks of America’s Dependence on China for Medicine, by Rosemary Gibson and Janardan Prasad Singh (2018). This book traces numerous health problems that have arisen in the U.S. from drugs, or drug ingredients, or medical devices that have been sourced from China. The book takes a confrontational tone, arguing that China’s goal is to dominate the world pharmaceutical market (at least for generics), and it is more than willing to employ all manner of shady practices to achieve this goal. It will do this by making sure it always has the lowest price, which seems to be the number one criteria in the U.S. for choosing drug suppliers. As with Bottle of Lies, much of the blame for problems with Chinese-produced “active ingredients” is that the FDA has great difficulties with inspecting manufacturing plants in China. Paperwork is scarce, quality testing is suspect, and over time China has come to become the dominant provider for a wide spectrum of medicines. Another theme echoing through the book is that China could provoke a crisis anytime it wants in the U.S. simply by cutting off our supply of critical medicines, including antibiotics and cancer drugs. The end of the book contains a list of suggested changes that should be made to U.S. policies to make sure this scenario never plays out. Every bit as scary as Bottle of Lies, but not as well written, or documented.