“Nothing big happens until you close the schools. It’s not like anything else. It’s like a phase change. It’s nonlinear. It’s like when water temperature goes from thirty-three to thirty-two. When it goes from thirty-four to thirty-three, it’s no big deal; one degree colder and it turns to ice.”

One way to reduce medical error, he thought, was to redesign the environment to make it more difficult for bad things to happen. “You cannot put a 120-volt plug into a 240-volt outlet,” he said, by way of analogy. “Why? You can’t do it! You can’t fit it in!” In medicine there were too many 120-volt plugs that fit into 240-volt outlets.

Carter now sensed when she might have changed her mind about him. Early on, they’d been discussing the pandemic plan, and he had shared with her his thoughts about maps. They were also his thoughts about plans, as a plan is a kind of map: a map of what you plan to do. He told her a story about some troops who’d gotten lost in the Alps. “They’re in

The new models of disease, slow and unwieldy though they were, gave Richard hope. D.A. Henderson, and the people at the CDC, along with pretty much everyone else in the public-health sector, thought that the models had nothing to offer; but they were missing the point. They, too, used models. They, too, depended on abstractions to inform their judg

Henderson might have left it at that, but for some reason he couldn’t. A month later he wrote a scathing three-page, single-spaced reply. It bothered him that this professor held himself out as a student of battlefield decisions without understanding their most important quality, uncertainty. “I have found that there is an order of magnitude differ

But the shift inside the CDC that had begun with the Swine Flu Affair had led it to become a different sort of place. “Now I understood why the CDC was so admired,” said Charity. “It was because of people like him.” But Sencer had also exposed the price of bravery. After Sencer—or after Foege—the CDC’s relationship to disease control had changed in

On a Red Dawn phone call in early March, she was laying out her ideas about what California and every state in the country should do when a new voice came on the line. “This is Ken,” it said. Ken Cuccinelli, the acting deputy secretary of homeland security and a member of Trump’s coronavirus task force. “He said, ‘Charity, you need to push these th

There was, Carter thought, a downside to experience. “Experience is making the same mistake over and over again, only with greater confidence,” he said. The line wasn’t his, but he liked it.

“They said, ‘You need to do these things one at a time and gather evidence.’ They wanted to learn from this meningitis outbreak, and I wanted to stop it. My goal was to stop it, and that was not their goal. They wanted to observe it as if it were a science experiment on how meningitis moves through a college campus. And I was like, ‘Are you kidding