Remember the start of the Covid-19 pandemic? Six years ago, most of us were in lockdown. No school. Working from home. A mysterious new virus was killing tens of thousands around the world, one spread by… infected people touching fruits and vegetables in the supermarket? 

So you had to scrub your fruit and veg when you got home? From your twice-monthly shopping trip? Wearing the mask your sister-in-law sewed from some fabric she’d bought to make quilts? While keeping the length of one hockey stick away from all the other shoppers, and stockpiling every package of toilet paper you could get your medical gloves on.

Looking back, we got so much wrong at the start of the pandemic. Among other things, we failed to understand that airborne transmission is the real culprit in the spread of the virus, which is formally known as severe acute respiratory syndrome coronavirus 2: SARS-CoV-2, or Covid-19. 

Fortunately, as journalist Jason Gale writes in his new book, After Covid,^[1] we’ve stopped believing much of the early misinformation, and benefited greatly from vaccines that were developed at unprecedented speed. 

Yet we’re also facing a host of consequences, most of which are poorly understood. Gale subtitles his book Health Impacts That Will Last Generations, and rolls out evidence showing that the pandemic was a nasty gift that keeps on giving, affecting the lives of survivors in unexpected ways. Among other things, figures show a surprising rise in the incidence of diabetes among people who had normal blood sugar levels before they got sick. Gale writes that many other health problems seem to be triggered by even mild cases of Covid, including multiple sclerosis and rheumatoid arthritis, and quotes the research to prove it.

He also points to another problem: getting people to believe the research. Over the past several years, we’ve fallen victim to a great deal of wrong advice, starting with disinfecting our fruit and veg. As a result, post-Covid society has become broadly skeptical of science, medicine and expertise, and far too vulnerable to conspiracy theories, along with the charlatans who push them.

I don’t think there’s any one reason why this happened. Social media. Declining standards of education. Galloping levels of income disparity, a gulf that leaves people mistrustful of the elite, which many see as including medical doctors and scientists.

But in his rigorous and detailed history of the Covid pandemic, Gale points to a couple of ways in which the pandemic itself fed the growing tendency to blame nebulous conspiracies when things go wrong. 

• Governments wanted to tamp down worry and avoid social unrest. So they lied. There are milder terms. You could say they downplayed the danger, discounted trends, under-counted deaths. Really, they just lied, and people knew it.
• Surprisingly, Gale also blames scientists. In their haste to find a treatment, some researchers publicized theories about the virus that they later retracted. They weren’t being malicious or trying to mislead. In fact, they wanted to be helpful. But people are prone to remember the few times things go dramatically wrong instead of the many times they go right. As a result, mistrust of science grew, along with an unfortunate skepticism toward vaccinations.

As Gale points out, this growing distrust leaves us ill-prepared for the next pandemic, which will happen. (Hantavirus? Ebola?) 

This makes his book an important read for its dispassionate grappling with what actually went on during the first four years of the pandemic, and what after-effects we can reasonably expect to see going forward. 

Jason Gale is an award-winning Australian journalist with Bloomberg News. He’s currently its biosecurity correspondent, a senior editor who holds an MA in public health. 

Gale opens his book by detailing the first signs of the outbreak in late 2019, when a puzzling new type of pneumonia emerged in Wuhan, China. The disease was originally reported among vendors in a so-called wet market, where live wild animals are sold to be butchered and eaten in restaurants, including racoon dogs and palm civets,^[2] mammals known to carry coronaviruses. Before reading the book, I hadn’t understood that the market was so big and rambling, the size of two soccer fields. But then, it lies in China’s seventh largest city, which has more than 13 million inhabitants. 

“How did it begin?” Gale asks. “The origins…remain shrouded in mystery. Beyond the early cluster of cases at the market, the trail quickly goes cold. The Peoples’ Republic of China, the first country affected, has had little incentive to fully investigate or disclose the virus’s beginnings.”

Instead, Chinese officials blamed the US military for the arrival of the virus, along with imported frozen food. Perhaps as a result of these obvious lies, another unsubstantiated theory began to circulate internationally: that the virus had been artificially engineered at the Wuhan Institute of Virology. The institute has two campuses located close to the wet market, and according to this theory, the Covid virus escaped from the lab to infect vendors. The allegation remains widely believed.

“However,” Gale notes, “there’s no public record of any researchers there working with a direct precursor to SARS-CoV-2.”

Instead, he quotes Chinese scientist Linfa Wang, who traced the origins of the deadly SARS virus in 2002 to a specific species of bat in Yunnan, China. Wang believes the bats transmitted the virus to wild animals, and that the same mechanism likely explains the emergence of Covid. 

“Exactly how (SARS) spilled over to infect people hundreds of miles away in Guangdong Province in late 2002 is still a mystery,” Gale writes. “However, palm civets and other wild animals sold in wet markets and served in restaurants have been implicated in at least some human infections.” 

Gale seems to side with the bat theory of Covid, at least given the evidence available so far. Yet it’s still early. “Understanding how pandemics start is crucial for prevention,” he notes. “But history isn’t written in real time. Narratives shift, uncomfortable truths are obscured, and the story of a pandemic becomes as much about memory as it is about fact.”

Not long ago, I reviewed a book published in 2025 in which historian David Nasaw demonstrates that a significant number of American soldiers returning home from World War II suffered from undiagnosed cases of Post Traumatic Stress Disorder.^[3] The war ended in 1945, 80 years before Nasaw published Wounded Warriors. Only recently has he been able to examine declassified military documents, and to read the memoirs of soldiers in light of modern medical insights. Together they help him make his case.

Writing only a few years after the eruption of Covid, Jason Gale has a limited amount of undisputed data to work with and a great many conspiracy theories to debunk. Scientists struggled—and still struggle—to understand a novel virus that frequently mutates. We know governments lied, yet the truth remains locked in classified files.

There’s also the fact that in the confusion of the moment, bureaucrats failed to collect relevant data, and true figures are only slowly leaking out. A story published by Scientific American on March 18 quotes a new study as showing that Covid probably killed 150,000 more people in the U.S. during the first two years of the pandemic than official figures show. Many were marginalized people whose deaths weren’t properly recorded. Add them in, and the U.S. death toll for 2020 and 2021 rises to nearly 1,000,000.^[4]

All of this makes Gale’s book something like a first rough draft of history, as journalism has often been called.^[5] Yet Gale is rigorous and detailed in setting down what’s currently known, and especially in exposing government lies and failures during the first days of the pandemic. 

Publicly, U.S. President Donald Trump said the virus was “under control” and would “mysteriously disappear.” In private, he called it “deadly stuff,” and was reportedly furious when an official from the Centres for Disease Control warned that it would cause severe social disruption, a prediction that tanked the stock market. Trump ordered all future CDC releases to be channeled through Vice President Mike Pence, politicizing the medical data, and prioritizing the stock market over the health of US citizens. 

Meanwhile, as Denmark locked down, Sweden’s government tried for herd immunity and kept the country reasonably open. Gale shows that Denmark suffered “very few” deaths, while 10,000 people died in Sweden. 

He also offers a sobering list of possible long-term consequences for people who’ve suffered even a mild case of Covid.

• Kidney specialist and epidemiologist Ziyad Al-Aly reported being startled by data suggesting that Covid survivors “were developing diabetes at alarming rates…Covid wasn’t just deadlier for people with diabetes, it was triggering the disease in people who had never had it before.”
• Gale shows that other researchers have uncovered links between Covid and declining bone health, a higher risk of developing rheumatoid arthritis, multiple sclerosis, and over a dozen other autoimmune and collective tissue disorders.
• Medical researchers have also found that children born to mothers infected with Covid during pregnancy tend to have lower birth weights. This is often followed by rapid weight gain in the first year of life, a catch-up that the mothers find reassuring. Yet post-World War II studies showed the same pattern in children born during the so-called Hunger Winter in the Netherlands during the last year of Nazi occupation. Those affected ran an unusually high risk of obesity and metabolic disorders later in life.
• Then there’s Long Covid. When doctors failed to take patients’ early reports of Long Covid seriously, they began researching the condition themselves. “Using translations into nine languages,” Gale writes, “the Patient-Led Research Collaborative gathered survey data from communities hardest hit by the virus, drawing on the experiences of more than 3,700 patients across 56 countries who had been infected during the pandemic’s first six months. The resulting study identified 205 Long Covid symptoms across nearly every bodily system.” The changes they reported have spurred further studies to trace the effects of these symptoms going forward.

With the pandemic declared to be over, Covid is now treated like influenza and the common cold—a relatively mild endemic disease we vaccinate against a couple of times a year. (At least, many of us do). It’s probably more serious than that, as the ongoing studies of its long-term effects suggest. Gale can’t close his book with a requiem for the disease, but instead he issues a warning. Society needs to prepare. 

“The next pandemic will come. What we do between now and then will determine whether it finds us wiser—or simply older.”

Are we ready? With a hantavirus outbreak that began on board the cruise ship M.V. Hondius in the news?^[6]

The hantavirus is usually only spread between rodents. But the Hondius outbreak is attributed to the rare Andes variant which can spread from person to person. Patient Zero was a Dutch ornithologist who birdwatched at a dump in Argentina, where doctors believe he contracted the virus. He and his wife then boarded the Hondius in Buenos Aires. Both subsequently died, along with one other passenger. Eight others are currently ill. 

And what about the outbreak of Ebola in Uganda and the Democratic Republic of Congo? The rare Bundibugyo virus behind the current outbreak has recently killed 131 people, while around 500 people are ill with suspected cases. 

No approved medicines or vaccines exist to combat the Bundibugyo variant, and on Sunday the World Health Organization called it “a public health emergency of international concern.”

____________________________________

^[1] After Covid: The Health Impacts That Will Last Generations by Colin Gale is published by Johns Hopkins University Press. You can order it here.

^[2] Russian playwright Anton Chekhov bought what he thought were two half-grown mongooses during a stop in Ceylon (Sri Lanka) on his way home from a trip to Siberia. One turned out to be a female palm civet, or palm cat, and untamable. Chekhov gave it to a zoo in Moscow after his return. The other was in fact a mongoose and liked to sit on Chekhov’s lap. He named it Svoloch, which means bastard in Russian. I happen to know this since Chekhov is a character in the novel I’ve just finished writing. So is the mongoose, while the palm civet has a cameo. (“Mongooses” is the correct plural, in case you were wondering.)

^[3] The Wounded Generation: Coming Home from World War II  by David Nasaw. I did a two-part review of the book, and you can read the first part here. Both reviews include a link that lets you buy Nasaw’s book, which is also available in most libraries.  

^[4] You can read the Scientific American article here.

^[5] Washington Post publisher Philip Graham is usually credited with calling journalism “the first rough draft of history” in 1963. However, this article in Slate magazine shows the phrase first cropped up in 1943 in a New Republic book review by journalist Alan Barth, and was commonly used in the Post during the 1940s. Barth was an editorial writer there from 1943 to 1972. The phrase appears in the Post both before and after Graham became publisher in 1946, and Slate writer Jack Shafer takes a guess that Barth was the original author of the phrase. He figures it might have been dropped into a speech written for Graham by members of the editorial board. 

^[6] The Nation says we’re far from ready. In fact, a May 13 article is headlined: “The Hantavirus Isn’t the Biggest Threat We’re Facing. The government’s destruction of our pandemic preparedness is.” Below it is a photo of Robert Kennedy Jr. You can read the article here.