‘The Premonition’: Two Takeaways for Government

Over the next several years, books about the COVID-19 pandemic will be a growth industry. One of the first out of the gate is Michael Lewis’ The Premonition. While future books will likely offer chronological accounts of decision-making and the consequences, Lewis does what he does best—he tells impressionistic “stories” based on the first-hand experience of interesting people.    

Lewis presents the pandemic from the vantage point of three individuals. The three “heroes” of the book are Charity Dean, a public health doctor with experience working at the county and state level in California; Carter Mecher, a career civil servant in the Department of Veterans Affairs; and Joe DeRisi, a biochemist at the University of California-San Francisco. Each played a role in providing early warnings about the forthcoming pandemic to individuals throughout the various levels of government. By seeing government performance through the eyes of Dean, Mecher, and DeRisi, there is much to learn. There are two major takeaways.

First: American governance is messy, disorganized, disconnected, and unwieldy. While this will surprise no one, Lewis presents a powerful description of governance that should make all government leaders seriously analyze how they can make government work better in the years ahead. Lewis writes: 

“One day some historian will look back and say how remarkable it was that these strange folks who called themselves ‘Americans’ ever governed themselves at all … Inside the United States were all these little boxes … Each box became its own small, frozen world, with little ability to adapt and little interest in whatever might be going on inside the other boxes … One box might contain the solution to a problem in another box, or the person who might find that solution, and that second box would never know about it.”

The 300 pages of The Premonition provides descriptions of how government “boxes” looked to Dean, Mecher and DeRisi from their perspective. Lewis also presents the first-hand experiences of his three protagonists prior to 2020 and the start of the pandemic. He devotes much attention to Dean’s experience as a public health doctor, writing, “The larger apparatus of American public health was very different on the inside from how Charity had imagined it from the outside. The Centers for Disease Control, the apex authority, wasn’t of much practical use to her.” Lewis describes an outbreak of meningitis at the University of California at Santa Barbara where Dean was responsible for responding to and managing the crisis. He quotes Dean: “’I was always saying to the CDC, ‘This is your job! Do your job! 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.’”

The problem of “boxes” has long been the subject of numerous academic studies. The public administration literature is full of articles on collaboration, networks, “boundary spanning,” and so on. There will undoubtedly be more studies and conversations about the jurisdictional problems in the years ahead. The pandemic provided clear evidence that our current inter-governmental system is not working. While the United States has muddled through (to be put it mildly) the pandemic to date, there is a clear need for future improvements. Much of the first half of 2020 was spent with governors and the White House arguing about which level of government was responsible for which specific activities. 

Second: The use of informal professional networks, or “backdoor” bureaucracy, can be a powerful mechanism. While Lewis does not label the ongoing communications among Mecher and his colleagues as a professional network, the stories presented by Lewis do indeed demonstrate the power of a network. In many ways, the networking presented by Lewis is a response to the disjointed and disconnected layers of American government. 

One of the most powerful stories in The Premonition is the work of the “Wolverines,” an informal network of seven doctors who came together over more than a decade each time a biological threat presented itself. Lewis writes, “MERS, Ebola, Zika: they’d all been involved in each of these outbreaks, one way or another, behind the scenes. In flurries of phone calls and emails, they’d seek to figure out what was going on, and what each might do to influence the situation and save lives.” On January 8, 2020, Mecher activated the network by typing an email to Richard Hatchett, a former colleague when both served in the Bush White House in 2005. Lewis observes that Mecher and Richard “never really stopped working together” over the next 15 years. 

As professionals, civil servants at all levels of government really have two jobs: one working inside the bureaucracy and another job working outside the bureaucracy in professional networks across boundaries. In the Foreign Service, backdoor diplomacy has long been a tool that foreign service officers deploy in doing their jobs. For civilians, Lewis describes a backdoor bureaucracy in which professionals exchange information, ideas, and contacts. The Premonition shows how this backdoor bureaucracy worked as America struggled to effectively respond to the pandemic in 2020-2021.

In emails and phone calls, the Wolverines concluded that one of their goals was “to find at least one state to take the lead and roll out an aggressive response to the virus, introduce the social interventions outlined in the pandemic plan, and create a domino effect.” One member of the group knew and reached out to Charity Dean in California. Lewis presents the experience of Dean in working with California Governor Gavin Newsome to become the first state to issue a stay-at-home order. 

America has much to learn from its response to the pandemic. No doubt many books will be written about how we might have done better. Michael Lewis has provided us with a good starting point for that discussion.    

Mark A. Abramson is president of Leadership Inc. His most recent book is Government for the Future: Reflection and Vision for Tomorrow’s Leaders (with Daniel J. Chenok and John M. Kamensky). His email address is mark.abramson@comcast.net.