Why take seriously a book on a pandemic written by a student of politics who has never studied medicine?

One of the mantras of South Africa's official response to Covid-19 (and that of many other countries) was that we should respond to the virus by ‘following the science’. While this was an understandable response to an earlier failure to take science seriously – the government's response to HIV and Aids during the early years of the twenty-first century – it created its own problems, chief among them the assumption that there is an undisputed ‘science’of Covid-19 which is available only to medical scientists – ‘experts’ who are, therefore, infallible messengers of the revealed truth. This too was central to the way in which the country's elites first responded to the disease. It ensured a slavish reverence for medical scientists, even when their claims appeared to ignore evidence available in the daily news, or were proved to be simply wrong, and served largely to close down public debate on the government's medical response to the virus. And, while some scientists complained incessantly that the government ignored their advice,1 they differed with it only on detail, not principle. Both presented the opinions of medical scientists as ‘the science’ – the only response to the pandemic based on knowledge.

But the fight against a public health threat is never only (and often not mainly) about access to medical science. If it was, South Africa would boast the lowest case and death numbers in Africa because it has more medical scientists and medical technology than other countries on the continent. But its case numbers and deaths are, in reality, the highest on the continent. Protecting public health is inevitably a social and political activity because it is, to a large degree, about how people behave; its goal is to encourage or force people to act in ways most likely to keep them alive and healthy. Medical science hopes to tell us how a health threat operates and what can be done to avoid it or to treat it. It cannot tell us how to ensure that people do what is required, whether those people are government ministers, those who wield private power over providing health care, or the citizenry.