The Pandemic Perhaps: Dramatic Events in a Public Culture of Danger by Carlo Caduff (review)

Caduff’s book is an ethnography of what he calls pandemic prophecy—or the scientific narrative that claims a widespread and deadly outbreak of infectious disease is all but guaranteed, the “not if, but when” story of the coming plague. The infectious agent typically at the core of these predictions is a novel strain of influenza. Each outbreak or pandemic is merely a “proxy for the coming pandemic” (p. 150). This is the crux of Caduff’s argument and represents a new perspective, extending the literature on risk and preparedness in the social sciences. Caduff’s careful reading of history—and his deft blending of history and ethnography—also makes this book an interesting addition to the history of pandemics, infectious disease, and epidemiology.

In six chapters, Caduff traces the century-long history of influenza research, key events during the similarly mild 1976 and 2009 influenza pandemics (and their mismanaged vaccine production), recent debates about the safety of lab research on “bird flu” and the fight to publish scientific findings from such research, and public health preparedness exercises and drills meant to illustrate gaps in policy and planning before another pandemic occurs. A rich and well-written ethnography of influenza expertise, this book highlights all the ways in which history is productively woven into modern narratives about pandemics writ large. As he convincingly argues about the fizzled 1976 influenza pandemic, “recollections of the past and anticipations of the future became almost indistinguishable” (p. 71).

Although the specter of influenza pandemics have driven much of public health planning around the globe, Caduff focuses in on the “visions” of infectious disease experts and their reverberations in public discourse within the United States. His central question is: Why are American prophecies about a future influenza pandemic so successful? The answer involves taking “prophetic temporality seriously as a social fact” (p. 21). While prophecy necessarily resides in the not-so-distant future, it also has to continuously be made present. The past has to be conjoined with the future for pandemic prophecy to work effectively.

Prophetic temporality produces a weird phenomenological effect. Actual outbreaks—such as the 2009 H1N1 pandemic of the 2015 Ebola outbreak—are experienced as events, but not the real event. In this way, the 2009 H1N1 pandemic is reframed as a global test for our public health systems. It’s conceptualized as an opportunity for lessons to be learned, for gaps in preparedness to be discovered before the next pandemic occurs. But these gaps can never, Caduff argues, be completely closed—they need to remain gaps for the work of public health to continue.

The past doesn’t just repeat itself in this book – we repeat ourselves. By anticipating pandemics based on a historical event (like the infamous killer 1918 pandemic), we accidentally recreate them over and over again. When a pandemic flops, as in 1976 or in 2009, we are surprised and almost disappointed. These pandemics were only failures by the standard set by the 1918 influenza pandemic. By expecting another 1918, history itself becomes prophecy (p. 66). The historical writings about the 1918 pandemic are no longer just records of past happenings, but predictive texts, meant to be interpreted by scientific prophets and used to proselytize the coming plague to the masses.

Caduff places this pandemic prophecy at the intersection of reason and faith, suggesting that faith “operates at the heart of reason, not at its limits or margins” (p. 21). One has to have faith in the coming pandemic for it to function as the center of a billion-dollar research and preparedness industry. The histories of past pandemics and outbreaks are used to ground faith in a coming plague. Events that happen aren’t important unless they can be read through this prophetic past. Prophetic speech about the coming plague is interesting to Caduff precisely because it always fails to produce the thing it anticipates...