Eye on the enemy

Nature wants you dead. Not just you, but your children and everyone you have ever met and everyone they have ever met; in fact everyone”. British researcher John S. Tregoning’s Infectious: Pathogens and How We Fight Them is a book that starts with this scary statement. And, as we proceed with its pages, we would encounter some scary science facts, too. However, Tregoning, who is currently a reader in respiratory infections at Imperial College, London, makes sure to explain these hard ideas in simple language—with abundant use of witty analogies—for the readers.

The book is a product of the pandemic. Tregoning started working on it in March 2020—a stage when total deaths from Covid-19 were less than 3,000. By the time he reached the last chapter, the toll reached 2,230,000. This pandemic timeline from March 2020 to January 31, 2021, could be seen in the book.

“I have been working as a research scientist studying infectious diseases for the last 20 years. I have spent a lot of that time trying to understand how and why we get sick from airborne pathogens. However, it was only in 2020, at the beginning of the Covid-19 pandemic, that I really appreciated the thirst for knowledge about viruses and infections,” says Tregoning. “This was an opportunity to share what I have learned with a wider audience to help people understand what has just happened and what they can do to protect themselves against future outbreaks.”

The book rightly notes that we are in a far better position to fight infections compared with our past generations. “As a result of science’s success, even during a full-blown pandemic most of us will die of non-infectious causes, in stark contrast to a hundred years ago, when many more people died of infections than other causes. The tipping point came somewhere in the 1950s when the cumulative effect of access to clean water and increased vaccine coverage changed our relationship with microorganisms,” it says. And, the book celebrates this massive success of the medical field in the past 100 years.

Infectious is broadly divided into two parts. Part 1 discusses the science behind infections and how the body’s immune system fights them. It also discusses the various diagnostic tools used to identify the culprits behind infections. In part 2, Tregoning offers bits of advice for the prevention, control and treatment of infections.

One long chapter in part 2 is about how vaccines work. Tregoning notes that vaccines are based around the simple principle that our immune system can remember things it has seen previously. And, along with explaining the impact of vaccination drives, Tregoning offers a commentary on the problem of misinformation campaigns against vaccines. “I think it is important not to over-promote anti-vaxxers; they are highly vocal, but are a very low proportion of the population,” he writes. He also explains how Covid-19 vaccines were brought out in record-breaking time. “This was achieved through massive investment, both in the research to generate the new candidates and in the manufacturing,” says the book. The vaccine makers took a huge financial risk, too: “To coordinate the delivery of the vaccine with the end of the clinical trials, doses of vaccines were made even before it was known if they were safe or effective, some of which will no doubt end up going down the drain.” He ends the chapter saying that vaccines are “a success story of human science and innovation, up there with the moon landing, Swiss army knives and the internet”.

It will be wrong to tag Infectious as a book about medical facts alone. It offers some very relevant sociological observations, too. For instance, it talks about “the sorry state of affairs surrounding the Covid-19 pandemic” in some quarters. The writer says that the fear factor, the absence of actual information about the virus (at least in the first phase) and the disruption the world had witnessed in a short span led to the deluge of fraudulent theories about the Covid-19 pandemic.

The book offers some interesting historical anecdotes, too. For instance, Tregoning unearths a rare connection Nobel Prize-winning British chemist Dorothy Hodgkin had with the Iron Lady of Britain–Margaret Thatcher was once a student in Hodgkin’s lab.

The book also talks at length about the development of antibiotic, antimicrobial, anti-viral and anti-parasitic drugs, and also about an impending “post-antibiotic apocalypse”. Says Tregoning: “With climate change and the changes in the way that people live and interact with the environment, it is certainly possible that there will be more pandemics in the future. We are living through another, slower-burning pandemic—that of antibiotic-resistant bacteria. These are pathogens that are not treatable with our existing drugs.”

The researcher notes that continued investment in basic research and understanding how the body fights infections are vital to deal with these threats. “We also need investment in national-level manufacturing for vaccines and drugs, which will help achieve greater equality in how infectious diseases are controlled,” he says.

Infectious: Pathogens and How We Fight Them

Dr John S. Tregoning

Publisher: Simon & Schuster

Pages: 374

Price: Rs699